WorldWideScience

Sample records for operations control room

  1. Human reliability analysis of control room operators

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Isaac J.A.L.; Carvalho, Paulo Victor R.; Grecco, Claudio H.S. [Instituto de Engenharia Nuclear (IEN), Rio de Janeiro, RJ (Brazil)

    2005-07-01

    Human reliability is the probability that a person correctly performs some system required action in a required time period and performs no extraneous action that can degrade the system Human reliability analysis (HRA) is the analysis, prediction and evaluation of work-oriented human performance using some indices as human error likelihood and probability of task accomplishment. Significant progress has been made in the HRA field during the last years, mainly in nuclear area. Some first-generation HRA methods were developed, as THERP (Technique for human error rate prediction). Now, an array of called second-generation methods are emerging as alternatives, for instance ATHEANA (A Technique for human event analysis). The ergonomics approach has as tool the ergonomic work analysis. It focus on the study of operator's activities in physical and mental form, considering at the same time the observed characteristics of operator and the elements of the work environment as they are presented to and perceived by the operators. The aim of this paper is to propose a methodology to analyze the human reliability of the operators of industrial plant control room, using a framework that includes the approach used by ATHEANA, THERP and the work ergonomics analysis. (author)

  2. Feasibility of touch-less control of operating room lights.

    Science.gov (United States)

    Hartmann, Florian; Schlaefer, Alexander

    2013-03-01

    Today's highly technical operating rooms lead to fairly complex surgical workflows where the surgeon has to interact with a number of devices, including the operating room light. Hence, ideally, the surgeon could direct the light without major disruption of his work. We studied whether a gesture tracking-based control of an automated operating room light is feasible. So far, there has been little research on control approaches for operating lights. We have implemented an exemplary setup to mimic an automated light controlled by a gesture tracking system. The setup includes a articulated arm to position the light source and an off-the-shelf RGBD camera to detect the user interaction. We assessed the tracking performance using a robot-mounted hand phantom and ran a number of tests with 18 volunteers to evaluate the potential of touch-less light control. All test persons were comfortable with using the gesture-based system and quickly learned how to move a light spot on flat surface. The hand tracking error is direction-dependent and in the range of several centimeters, with a standard deviation of less than 1 mm and up to 3.5 mm orthogonal and parallel to the finger orientation, respectively. However, the subjects had no problems following even more complex paths with a width of less than 10 cm. The average speed was 0.15 m/s, and even initially slow subjects improved over time. Gestures to initiate control can be performed in approximately 2 s. Two-thirds of the subjects considered gesture control to be simple, and a majority considered it to be rather efficient. Implementation of an automated operating room light and touch-less control using an RGBD camera for gesture tracking is feasible. The remaining tracking error does not affect smooth control, and the use of the system is intuitive even for inexperienced users.

  3. Response Times of Operators in a Control Room

    DEFF Research Database (Denmark)

    Platz, O.; Rasmussen, J.; Skanborg, Preben Zacho

    A statistical analysis was made of operator response times recorded in the control room of a research reactor during the years 1972-1974. A homogeneity test revealed that the data consist of a mixture of populations. A small but statistically significant difference is found between day and night ...... response times. Lognormal distributions are found to provide the best fit of the day and the night response times....

  4. Operational Strategy of CBPs for load balancing of Operators in Advanced Main Control Room

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seunghwan; Kim, Yochan; Jung, Wondea [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    With the using of a computer-based control room in an APR1400 (Advanced Pressurized Reactor-1400), the operators' behaviors in the main control room had changed. However, though the working environment of operators has been changed a great deal, digitalized interfaces can also change the cognitive tasks or activities of operators. First, a shift supervisor (SS) can confirm/check the conduction of the procedures and the execution of actions of board operators (BOs) while confirming directly the operation variables without relying on the BOs. Second, all operators added to their work the use of a new CBP and Soft Controls, increasing their procedural workload. New operational control strategies of CBPs are necessary for load balancing of operator's task load in APR1400. In this paper, we compared the workloads of operators in an APR1400 who work with two different usages of the CBP. They are SS oriented usage and SS-BO collaborative usage. In this research, we evaluated the workloads of operators in an advanced main control room by the COCOA method. Two types of CBP usages were defined and the effects of these usages on the workloads were investigated. The obtained results showed that the workloads between operators in a control room can be balanced according to the CBP usages by assigning control authority to the operators.

  5. Mission Operations Control Room Activities during STS-2 mission

    Science.gov (United States)

    1981-01-01

    Mission Operations Control Room (MOCR) activities during STS-2 mission. Overall view of the MOCR in the Johnson Space Center's Mission Control Center. At far right is Eugene F. Kranz, Deputy Director of Flight Operations. At the flight director console in front of Kranz's FOD console are Flight Directors M.P. Frank, Neil B. Hutchinson and Donald R. Puddy as well as others (39506); Wide-angle view of flight controllers in the MOCR. Clifford E. Charlesworth, JSC Deputy Director, huddles with several flight directors for STS-2 at the flight director console. Kranz, is at far right of frame (39507); Dr. Christopher C. Kraft, Jr., JSC Director, center, celebrates successful flight and landing of STS-2 with a cigar in the MOCR. He is flanked by Dr. Maxime A Faget, left, Director of Engineering and Development, and Thomas L. Moser, of the Structures and Mechanics Division (39508); Flight Director Donald R. Puddy, near right, holds replica of the STS-2 insignia. Insignias on the opposite wall

  6. Control of the Environment in the Operating Room.

    Science.gov (United States)

    Katz, Jonathan D

    2016-09-23

    There is a direct relationship between the quality of the environment of a workplace and the productivity and efficiency of the work accomplished. Components such as temperature, humidity, ventilation, drafts, lighting, and noise each contribute to the quality of the overall environment and the sense of well-being of those who work there.The modern operating room is a unique workplace with specific, and frequently conflicting, environmental requirements for each of the inhabitants. Even minor disturbances in the internal environment of the operating room can have serious ramifications on the comfort, effectiveness, and safety of each of the inhabitants. A cool, well-ventilated, and dry climate is optimal for many members of the surgical team. Any significant deviation from these objectives raises the risk of decreased efficiency and productivity and adverse surgical outcomes. A warmer, more humid, and quieter environment is necessary for the patient. If these requirements are not met, the risk of surgical morbidity and mortality is increased. An important task for the surgical team is to find the correct balance between these 2 opposed requirements. Several of the components of the operating room environment, especially room temperature and airflow patterns, are easily manipulated by the members of the surgical team. In the following discussion, we will examine these elements to better understand the clinical ramifications of adjustments and accommodations that are frequently made to meet the requirements of both the surgical staff and the patient.

  7. Operating room manager game

    NARCIS (Netherlands)

    Hans, Erwin W.; Nieberg, Tim

    2007-01-01

    The operating room (OR) department of a hospital forms the heart of the organization, where the single largest cost is incurred. This document presents and reports on the “Operating Room Manager Game,” developed to give insight into managing a large hospital's OR department at various levels of cont

  8. Psychological factors of professional success of nuclear power plant main control room operators

    Directory of Open Access Journals (Sweden)

    Kosenkov A.A.

    2014-12-01

    Full Text Available Aim: to conduct a comparative analysis of the psychological characteristics of the most and least successful main control room operators. Material and Methods. Two NPP staff groups: the most and least successful main control room operators, who worked in routine operating conditions, were surveyed. Expert evaluation method has been applied to identify the groups. The subjects were administered the Minnesota Multiphasic Personality Inventory (MMPI, Cattell's Sixteen Personality Factor Questionnaire (16PF form A and Raven's Progressive Matrices test. Results. Numerous significant psychological differences between the groups of most and least successful control room operators were obtained: the best operators were significantly more introverted and correctly solved more logical tasks with smaller percentage of mistakes under time pressure than worst ones. Conclusions: 1. The psychodiagnostic methods used in the study were adequate to meet research objective 2. Tendency to introversion, as well as developed the ability to solve logic problems undertime pressure, apparently, are important professional qualities for control room operators. These indicators should be considered in the process of psychological selection and professional guidance of nuclear power plant operators.

  9. HYBRID ALARM SYSTEMS: COMBINING SPATIAL ALARMS AND ALARM LISTS FOR OPTIMIZED CONTROL ROOM OPERATION

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring; J.J. Persensky

    2012-07-01

    The US Department of Energy (DOE) is sponsoring research, development, and deployment on Light Water Reactor Sustainability (LWRS), in which the Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe operational life extension of current nuclear power plants. One of the main areas of focus is control room modernization. Within control room modernization, alarm system upgrades present opportunities to meet the broader goals of the LWRS project in demonstrating the use and safety of the advanced instrumentation and control (I&C) technologies and the short-term and longer term objectives of the plant. In this paper, we review approaches for and human factors issues behind upgrading alarms in the main control room of nuclear power plants.

  10. Automation inflicted differences on operator performance in nuclear power plant control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Jonas; Osvalder, A.L. [Chalmers Univ. of Technology, Dept. of Product and Producton Development (Sweden)

    2007-03-15

    Today it is possible to automate almost any function in a human-machine system. Therefore it is important to find a balance between automation level and the prerequisites for the operator to maintain safe operation. Different human factors evaluation methods can be used to find differences between automatic and manual operations that have an effect on operator performance; e.g. Predictive Human Error Analysis (PHEA), NASA Task Load Index (NASA-TLX), Halden Questionnaire, and Human Error Assessment and Reduction Technique (HEART). Results from an empirical study concerning automation levels, made at Ringhals power plant, showed that factors as time pressure and criticality of the work situation influenced the operator's performance and mental workload more than differences in level of automation. The results indicate that the operator's attention strategies differ between the manual and automatic sequences. Independently of level of automation, it is essential that the operator retains control and situational understanding. When performing a manual task, the operator is 'closer' to the process and in control with sufficient situational understanding. When the level of automation increases, the demands on information presentation increase to ensure safe plant operation. The need for control can be met by introducing 'control gates' where the operator has to accept that the automatic procedures are continuing as expected. Situational understanding can be established by clear information about process status and by continuous feedback. A conclusion of the study was that a collaborative control room environment is important. Rather than allocating functions to either the operator or the system, a complementary strategy should be used. Key parameters to consider when planning the work in the control room are time constraints and task criticality and how they affect the performance of the joint cognitive system.However, the examined working

  11. Local control room

    CERN Multimedia

    CERN PhotoLab

    1972-01-01

    Local control room in the ejection building : all electronics pertaining to proton distribution and concomitants such as beam gymnastics and diagnostics at high energies will eventually be gathered here. Shown is the first of two rows of fast ejection electronic racks. It includes only what is necessary for operation.

  12. Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

    Energy Technology Data Exchange (ETDEWEB)

    R. Fink, D. Hill, J. O' Hara

    2004-11-30

    Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

  13. Development of Alarm System link Drawing for Operation Support for APR1400 Digital Main Control Room

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki-Hwan [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    Digitalized MMI(Man-Machine Interface) including Digital Main Control Room(MCR) and digital I and C system was being applied for SKN 3 and 4 Nuclear Power Plant(NPP) and subsequent APR1400 NPP type. But, operators can not easily find instrument for alarm immediately. Therefore, Alarm system is required to easily find instrument for Alarm. For this implementation, we will plan system design considering design feature without affecting network load and CPU load. We have developed Alarm system link drawing for digital MCR. Operators of the digitalized MCR navigates from their consoles to the drawings related to the plant alarms and their instruments or the operation status. Such method gives cognitive load to the operators having to travel to different locations in finding the related information. Screen Sharing System, which is the fundamental technique for Drawing Interconnection Alarm System is close to completion, and it should be functionally tested and verified by the human factor engineering. For the actual application to the operating plants, the drawings to be interconnected to the alarms and the opinions from the operators/maintenance departments for designating alarm number should be surveyed, Also, another function that allows the access to the alarm related drawings not only from the MCR but also from the other offices.

  14. Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Tyler Gonzalez

    2016-01-01

    Full Text Available Background: The most expensive variable in the operating room (OR is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p

  15. ISOLDE target zone control room

    CERN Multimedia

    2016-01-01

    Operating the ISOLDE target handling robots from the dedicated control room in building 197. Monitors showing the movements of the robots (GPS in this case) in the target zone. The footage shows the actual operation by the operator as well as the different equipment such as camera electronics, camera motor controls, camera monitors and Kuka robot controls touch panel.

  16. Light Water Reactor Sustainability Program Operator Performance Metrics for Control Room Modernization: A Practical Guide for Early Design Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Ronald Boring; Roger Lew; Thomas Ulrich; Jeffrey Joe

    2014-03-01

    As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate the operator performance using these systems as part of a verification and validation process. There are no standard, predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages of a new system. This report identifies the process and metrics for evaluating human system interfaces as part of control room modernization. The report includes background information on design and evaluation, a thorough discussion of human performance measures, and a practical example of how the process and metrics have been used as part of a turbine control system upgrade during the formative stages of design. The process and metrics are geared toward generalizability to other applications and serve as a template for utilities undertaking their own control room modernization activities.

  17. Full scope simulator of a nuclear power plant control room using 3D stereo virtual reality techniques for operators training

    Energy Technology Data Exchange (ETDEWEB)

    Aghina, Mauricio A.C.; Mol, Antonio Carlos A.; Almeida, Adino Americo A.; Pereira, Claudio M.N.A. [Instituto de Engenharia Nuclear (IEN-CNEN/RJ), Rio de Janeiro, RJ (Brazil)]. E-mails: mag@ien.gov.br; mol@ien.gov.br; adino@ien.gov.br; cmnap@ien.gov.br; Varela, Thiago F.B. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Programa de Engenharia Eletrica]. E-mail: phillips.rj@terra.com.br; Cunha, Gerson G. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Lab. de Metodos Computacionais em Engenharia (LAMCE)]. E-mail: gerson@lance.ufrj.br

    2007-07-01

    Practical training of nuclear power plants operators are partially performed by means of simulators. Usually these simulators are physical copies of the original control roam, needing a large space on a facility being also very expensive. In this way, the proposal of this paper is to implement the use of Virtual Reality techniques to design a full scope control room simulator, in a manner to reduce costs and physical space usage. (author)

  18. In the LEAR control room

    CERN Multimedia

    1983-01-01

    View into the control room of the Low Energy Antiproton Ring (LEAR). Edgar Asseo (sitting) and Dieter Möhl and Georges Carron reflecting upon some beam dynamics (or hardware?) problem. Vassilis Agoritsas, in the background, leaning over a plan or a keyboard. LEAR in its early years (1982 to about 1990) was run from this local control room in building 363 close to the end of the PS South Hall, where the ring was installed. Later-on the operation was surveyed from the PS main control room.

  19. Development of an evaluation methodology for operator`s moving distance workload for the assessment of the layout and arrangement of nuclear power plant control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Un; Seo, Sang Moon; Lee, Yong Hee; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1995-07-01

    In this report, link analysis is discussed for the assessment of control room layout and arrangement, among the workload assessment methodologies using SACOM. A methodology developed for estimating operator`s moving distances based on modified link analysis is described, including its detail algorithm. This methodology was developed with the type and content of SACOM input information in consideration of not only software aspects but also easiness when the designer use this for control room layout and arrangement. 1 tab., 7 figs., 8 refs. (Author) .new.

  20. A Novel Grid-Wide Transient Stability Assessment and Visualization Method for Increasing Situation Awareness of Control Room Operators

    DEFF Research Database (Denmark)

    Pertl, Michael; Rezkalla, Michel M.N.; Marinelli, Mattia

    2016-01-01

    The aim of the paper is to introduce a grid-wide assessment method to determine the transient stability margin and visualize it effectively to increase the situation awareness of control room operators. Critical area(s) with insufficient transient stability margin have to be identified in order...... to be able to take appropriate preventive actions. The introduced method evaluates the transient stability margin with a time-domain approach by using the voltage angle of several buses across the power system. Information about the severity of a contingency and the location of the most critical buses...... is derived. Moreover, it is shown that the method facilitates the visual examination of transient stability. It provides control room operators with essential information about the state of the system and enables them to take appropriate preventive actions if insufficient transient stability margins...

  1. A methodology for Living Probabilistic Safety Assessment (LPSA) based on Advanced Control Room Operator Support System (ACROSS)

    Energy Technology Data Exchange (ETDEWEB)

    Zubair, Muhammad, E-mail: zubairheu@gmail.com [College of Nuclear Science and Technology, Harbin Engineering University, 145 Nantong Street, Nangang District, Harbin, Heilongjiang 150001 (China); Zhang Zhijian, E-mail: zhangzhijian@hrbeu.edu.cn [College of Nuclear Science and Technology, Harbin Engineering University, 145 Nantong Street, Nangang District, Harbin, Heilongjiang 150001 (China); Khan, Salah Ud-din, E-mail: khanheu@gmail.com [College of Nuclear Science and Technology, Harbin Engineering University, 145 Nantong Street, Nangang District, Harbin, Heilongjiang 150001 (China)

    2011-06-15

    Highlights: > In this study we have introduced a methodology for Living Probabilistic Safety Assessment (LPSA). > Now the paper is focus on LPSA methodology for this purpose we introduced Advanced Control Room Operator Support System (ACROSS). > The ACROSS concept is new technique in LPSA and it's a part of our research project. > Detail is present in Section of paper. > We have also added to provide more detail about methodology. > We have remove Risk monitor portion from our paper and give more attention to LPSA methodology. - Abstract: In Probabilistic Safety Assessment (PSA) all attention is paid to analyze a system which is a time consuming effort so there is a need to develop a system network to support the analyst and to reduce manpower. To handle the physical, operational and organizational changes and to utilize the PSA information effectively the development of living Probabilistic Safety Assessment (LPSA) is essential. This paper presents a detailed methodology for LPSA. One part of this methodology is Advanced Control Room Operator Support System (ACROSS) which is helpful for updating the LPSA model. This methodology also provides help to make the control rooms in Nuclear Power Plants (NPPs) more advanced and user friendly. The study also makes recommendations for further use and development of this technique in the present and future NPPs.

  2. Economic analysis of linking operating room scheduling and hospital material management information systems for just-in-time inventory control.

    Science.gov (United States)

    Epstein, R H; Dexter, F

    2000-08-01

    Operating room (OR) scheduling information systems can decrease perioperative labor costs. Material management information systems can decrease perioperative inventory costs. We used computer simulation to investigate whether using the OR schedule to trigger purchasing of perioperative supplies is likely to further decrease perioperative inventory costs, as compared with using sophisticated, stand-alone material management inventory control. Although we designed the simulations to favor financially linking the information systems, we found that this strategy would be expected to decrease inventory costs substantively only for items of high price ($1000 each) and volume (>1000 used each year). Because expensive items typically have different models and sizes, each of which is used by a hospital less often than this, for almost all items there will be no benefit to making daily adjustments to the order volume based on booked cases. We conclude that, in a hospital with a sophisticated material management information system, OR managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the OR information system with the hospital's material management information system to achieve just-in-time inventory control. In a hospital with a sophisticated material management information system, operating room managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the operating room information system with the hospital's material management information system to achieve just-in-time inventory control.

  3. Investigation of the impact of main control room digitalization on operators cognitive reliability in nuclear power plants.

    Science.gov (United States)

    Zhou, Yong; Mu, Haiying; Jiang, Jianjun; Zhang, Li

    2012-01-01

    Currently, there is a trend in nuclear power plants (NPPs) toward introducing digital and computer technologies into main control rooms (MCRs). Safe generation of electric power in NPPs requires reliable performance of cognitive tasks such as fault detection, diagnosis, and response planning. The digitalization of MCRs has dramatically changed the whole operating environment, and the ways operators interact with the plant systems. If the design and implementation of the digital technology is incompatible with operators' cognitive characteristics, it may have negative effects on operators' cognitive reliability. Firstly, on the basis of three essential prerequisites for successful cognitive tasks, a causal model is constructed to reveal the typical human performance issues arising from digitalization. The cognitive mechanisms which they impact cognitive reliability are analyzed in detail. Then, Bayesian inference is used to quantify and prioritize the influences of these factors. It suggests that interface management and unbalanced workload distribution have more significant impacts on operators' cognitive reliability.

  4. PS Control Room

    CERN Multimedia

    CERN PhotoLab

    1963-01-01

    The good old PS Control Room, all manual. For each parameter, a knob or a button to control it; for each, a light or meter or oscilloscope to monitor it; carefully written pages serve as the data bank; phones and intercom for communication. D.Dekkers is at the microphone, M.Valvini sits in front.

  5. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators.

    Science.gov (United States)

    Kazemi, Reza; Haidarimoghadam, Rashid; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

    2016-02-03

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p sleep quality on both day and night shifts, and there were significant differences between the day and night shifts in terms of subjective sleep quality and quantity (p sleep, induced cognitive performance decline at the end of both day and night shifts, and increased sleepiness in night shift. It, thus, seems necessary to take ergonomic measures such as planning for more appropriate shift work and reducing working hours.

  6. [Management for the operating room].

    Science.gov (United States)

    Tschudi, O; Schüpfer, G

    2015-03-01

    Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail. Some OR-specific management challenges are worked out. From this it becomes clear that the economic logic of the most efficient implementation possible is not a contradiction of medical ethics, enabling the most effective treatment possible for patients while safeguarding the highest possible levels of safety and quality. The article aims to build a bridge for medical specialists to the language and world of commerce, emphasizing the profession-based competence and hopefully to arouse interest to go into more detail.

  7. Operation Room Infection Factors and Control%手术室感染因素及控制

    Institute of Scientific and Technical Information of China (English)

    姜丽; 周静

    2014-01-01

    The postoperative infection of patients means that the threat to life, so to prevent postoperative infection has become the guarantee of human life, an important task to promote the rehabilitation of patients and medical development. In order to reduce the infection rate of operation, improve the quality of medical treatment, the operation infection factors analysis. The results show that: the infection factors although many, but in general the main or operation contact and air bacteria through various means of land caused by operation wound infection in operation room, so is the key to control [1] infection, so the scientific management of operation room, take comprehensive measures and dynamic bacteriological monitoring is the fundamental way to reduce operation incision infection. Ensure work quality is the key to operation room infection reduce all kinds of operation after operation.%术后感染对患者意味着生命的威胁,因此防止术后感染已经成为当今保障人类生命,促进患者康复和医学发展的一个重大课题。为降低手术感染率,提高医疗质量,对手术感染因素进行分析。结果表明:感染因素虽然很多,但总的来说主要还是手术的接触传播和空气浮游菌通过各种途径降落于手术创面而引起的感染,所以手术室是控制切口感染的关键[1],因此对手术室进行科学管理,采取综合预防措施和动态细菌学监测是降低手术切口感染的根本途径。保证手术室工作质量是减少各类手术术后感染的关键。

  8. The vascular hybrid room--operating room of the future.

    Science.gov (United States)

    Hudorović, Narcis; Rogan, Suncica Andreja; Lovricević, Ivo; Zovak, Mario; Schmidt, Sasa

    2010-09-01

    The last two decades have seen a paradigm shift in the treatment of vascular related diseases from once traditional open surgical repairs to the entire vascular tree being amenable to percutaneous interventions. Neither the classic operating room nor the conventional angiography suite is optimal for both open surgery and endovascular procedures. Important issues for the vascular hybrid operating room include quality of the imaging equipment, radiation burden, ease of use of the equipment, need for specially trained personnel, ergonomics, ability to perform both open and percutaneous procedures, sterile environments, as well as quality and efficiency of patient care. The most important feature of working in a dedicated hybrid vascular suite should be the ability to attain best treatment of vascular patients. Whether the interventional radiologist or the vascular surgeon uses the facilities is of less importance. Establishment of an endovascular operating room suite has the benefit of a sterile environment, and the possibility of performing hybrid procedures and conversions when necessary. Moreover, angiography immediately before treatment gives contemporary anatomical information, and after treatment provides quality control. Consequently, better quality and service can be provided to the individual patient. These changes in the treatment of vascular disease require that a new type of vascular specialist, named 'vascular hybrid surgeon', trained to perform both endovascular and open surgical procedures in this highly complex patient group.

  9. Operating room of the future.

    Science.gov (United States)

    Bharathan, Rasiah; Aggarwal, Rajesh; Darzi, Ara

    2013-06-01

    Development of surgical care in the 21st century is increasingly dependent on demonstrating safety, efficacy and cost effectiveness. Over the past 2 decades, the potential role of simulation in surgery has been explored with encouraging results; this can now be linked to direct improvement in the quality of care provision. Computer-assisted surgical platforms, such as robotic surgery, offer us the versatility to embrace a host of technical and technological developments. Rapid development in nanomedicine will expand the limits of operative performance through improved navigation and surgical precision. Integration of the multiple functions of the future operating room will be essential in optimising resource management. The key to bringing about the necessary paradigm shift in the design and delivery of modern surgical care is to appreciate that we now function in an information age, where the integrity of processes is driven by apt data management.

  10. Development of an expert system for abnormal operating procedures in a main control room.

    Science.gov (United States)

    Hsieh, Min-Han; Hwang, Sheue-Ling; Liu, Kang-Hong; Liang, Sheau-Farn Max; Chuang, Chang-Fu

    2012-01-01

    The study was conducted from the perspective of human factors engineering in order to compare the process that operators originally used to diagnose potential and actual faults with a process that included an expert system for diagnosing faults. The results of the study indicated that the existence of an expert system for fault diagnosis makes the task of fault diagnosis easier and reduces errors by quickly suggesting likely Abnormal Operating Procedures (AOPs).

  11. Analysis of electricity distribution network operation business models and capitalization of control room functions with DMS

    Energy Technology Data Exchange (ETDEWEB)

    Tanskanen, A.

    2010-07-01

    Electricity distribution network operation (NO) models are challenged as they are expected to continue to undergo changes during the coming decades in the fairly developed and regulated Nordic electricity market. Network asset managers are to adapt to competitive technoeconomical business models regarding the operation of increasingly intelligent distribution networks. Factors driving the changes for new business models within network operation include: increased investments in distributed automation (DA), regulative frameworks for annual profit limits and quality through outage cost, increasing end-customer demands, climatic changes and increasing use of data system tools, such as Distribution Management System (DMS). The doctoral thesis addresses the questions a) whether there exist conditions and qualifications for competitive markets within electricity distribution network operation and b) if so, identification of limitations and required business mechanisms. This doctoral thesis aims to provide an analytical business framework, primarily for electric utilities, for evaluation and development purposes of dedicated network operation models to meet future market dynamics within network operation. In the thesis, the generic build-up of a business model has been addressed through the use of the strategic business hierarchy levels of mission, vision and strategy for definition of the strategic direction of the business followed by the planning, management and process execution levels of enterprise strategy execution. Research questions within electricity distribution network operation are addressed at the specified hierarchy levels. The results of the research represent interdisciplinary findings in the areas of electrical engineering and production economics. The main scientific contributions include further development of the extended transaction cost economics (TCE) for government decisions within electricity networks and validation of the usability of the

  12. Development of NPP control room operators`s mental workload measurement system using bioelectric signals

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Bong Sik; Oh, In Seok; Lee, Hyun Cheol; Cha, Kyung Ho [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Lee, Dong Ha [Suwon Univ., Suwon (Korea, Republic of)

    1996-09-01

    This study developed mentalload measurement system based on the relations between mentalload and physiological responses of the human operators. The measurement system was composed of the telemetry system for EEG, EOG, ECG and respiration pattern of the subjects, A/D converter, the physiological signal processing programs (compiled by the Labview). The signal processing programs transformed the physiological signal into the scores indicating mentalload status of the subjects and recorded the mentalload scores in the form of the table of a database. The acqknowledge and the labview programs additionally transformed the mentalload score database and the operator behavior database so that both database were consolidated into one. 94 figs., 57 refs. (Author).

  13. Microorganisms in Confined Habitats: Microbial Monitoring and Control of Intensive Care Units, Operating Rooms, Cleanrooms and the International Space Station.

    Science.gov (United States)

    Mora, Maximilian; Mahnert, Alexander; Koskinen, Kaisa; Pausan, Manuela R; Oberauner-Wappis, Lisa; Krause, Robert; Perras, Alexandra K; Gorkiewicz, Gregor; Berg, Gabriele; Moissl-Eichinger, Christine

    2016-01-01

    Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS) are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room), product quality has to be assured (cleanrooms), or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 - and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g., microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic) resistances in such environments - and the need to reassess the current hygiene standards.

  14. Microorganisms in confined habitats: Microbial monitoring and control of intensive care units, operating rooms, cleanrooms and the International Space Station

    Directory of Open Access Journals (Sweden)

    Maximilian Mora

    2016-10-01

    Full Text Available Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room, product quality has to be assured (cleanrooms, or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 – and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g. microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic resistances in such environments - and the need to reassess the current hygiene standards.

  15. Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room.

    Science.gov (United States)

    Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

    2016-01-01

    We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures.

  16. ISOLDE target zone control room HD

    CERN Multimedia

    2016-01-01

    Operating the ISOLDE target handling robots from the dedicated control room in building 197. Monitors showing the movements of the robots (GPS in this case) in the target zone. The footage shows the actual operation by the operator as well as the different equipment such as camera electronics, camera motor controls, camera monitors and Kuka robot controls touch panel.

  17. Performance of the Operating Room Personnel in following of the standards of Infection Control in the Educational Hospitals of Yasuj University of Medical Sciences in 2009

    Directory of Open Access Journals (Sweden)

    A Rostaminejad

    2011-04-01

    Full Text Available Introduction & Objective: Surgical wound infection is one of the common nosocomial infections. During operation, members of the surgical team which are in contact with the tissue incision should observe the standards of infection control in the operating room since it has a great role in prevention and control of these infections. The present study aimed to determine the performance of the operating room personnel in observing the standards of infection control in educational hospitals of Yasuj University of Medical Sciences in 2009. Materials & Methods: Forty two operating room personnel participated in this cross-sectional analytic-descriptive study. A check list was used for unnoticeably collecting the data about the performance of personnel in respect of infection control standards at three different times. Their performances were classified into four levels (very weak, weak, moderate and good and the results were shown as absolute and relative frequency distribution. Data were analyzed using Chi-square and Fischer exact test by the SPSS software. Results: Performance of personnel in following the standards of infection control in this study was moderate. Conclusion: The results indicate that the participants of the study do not follow some of the standards of infection control in the operating rooms. Therefore, further activities of the committees of infection control and using of new antiseptic for surgical scrub are recommended.

  18. Operating room management and operating room productivity: the case of Germany.

    Science.gov (United States)

    Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

    2008-09-01

    We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

  19. The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Control Centre for LHC operations, located in Prevessin.

    CERN Multimedia

    Husi C.

    2007-01-01

    The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Control Centre for LHC operations, located in Prevessin.

  20. New heuristics for planning operating rooms.

    NARCIS (Netherlands)

    Molina-Pariente, J.M.; Hans, E.W.; Framinan, J.M.; Gomez-Cia, T.

    2015-01-01

    We tackle the operating room planning problem of the Plastic Surgery and Major Burns Specialty of the University Hospital “Virgen del Rocio” in Seville (Spain). The decision problem is to assign an intervention date and an operating room to a set of surgeries on the waiting list, minimizing access t

  1. Automated Air Traffic Control Operations with Weather and Time-Constraints: A First Look at (Simulated) Far-Term Control Room Operations

    Science.gov (United States)

    Prevot, Thomas; Homola, Jeffrey R.; Martin, Lynne H.; Mercer, Joey S.; Cabrall, Christopher C.

    2011-01-01

    In this paper we discuss results from a recent high fidelity simulation of air traffic control operations with automated separation assurance in the presence of weather and time-constraints. We report findings from a human-in-the-loop study conducted in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. During four afternoons in early 2010, fifteen active and recently retired air traffic controllers and supervisors controlled high levels of traffic in a highly automated environment during three-hour long scenarios, For each scenario, twelve air traffic controllers operated eight sector positions in two air traffic control areas and were supervised by three front line managers, Controllers worked one-hour shifts, were relieved by other controllers, took a 3D-minute break, and worked another one-hour shift. On average, twice today's traffic density was simulated with more than 2200 aircraft per traffic scenario. The scenarios were designed to create peaks and valleys in traffic density, growing and decaying convective weather areas, and expose controllers to heavy and light metering conditions. This design enabled an initial look at a broad spectrum of workload, challenge, boredom, and fatigue in an otherwise uncharted territory of future operations. In this paper we report human/system integration aspects, safety and efficiency results as well as airspace throughput, workload, and operational acceptability. We conclude that, with further refinements. air traffic control operations with ground-based automated separation assurance can be an effective and acceptable means to routinely provide very high traffic throughput in the en route airspace.

  2. Software Support during a Control Room Upgrade

    Energy Technology Data Exchange (ETDEWEB)

    Michele Joyce; Michael Spata; Thomas Oren; Anthony Cuffe; Theo McGuckin; Isadoro Carlino; C. Higgins; Harry Fanning; Matthew Bickley; Brian Bevins

    2005-09-21

    In 2004, after 14 years of accelerator operations and commissioning, Jefferson Lab renovated its main control room. Changes in technology and lessons learned during those 14 years drove the control room redesign in a new direction, one that optimizes workflow and makes critical information and controls available to everyone in the control room. Fundamental changes in a variety of software applications were required to facilitate the new operating paradigm. A critical component of the new control room design is a large-format video wall that is used to make a variety of operating information available to everyone in the room. Analog devices such as oscilloscopes and function generators are now displayed on the video wall through two crosspoint switchers: one for analog signals and another for video signals. A new software GUI replaces manual configuration of the oscilloscopes and function generators and helps automate setup. Monitoring screens, customized for the video wall, now make important operating information visible to everyone, not just a single operator. New alarm handler software gives any operator, on any workstation, access to all alarm handler functionality, and multiple users can now contribute to a single electronic logbook entry. To further support the shift to distributed access and control, many applications have been redesigned to run on servers instead of on individual workstations.

  3. 49 CFR 192.631 - Control room management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management. (a... operator must have and follow written control room management procedures that implement the requirements...

  4. Difficult points and countermeasures for hospital infection control in operating room%手术室医院感染控制的难点及对策

    Institute of Scientific and Technical Information of China (English)

    冯迎辉

    2011-01-01

    Objective:To solve the difficulties of controlling hospital infection in operating room and give some solutions to this problem in order to improve the quality of nursing. Methods: The problems which found in our hospital in daily work were analyzed, improved and summaried, such as the operating room environment, the management of sterile goods, hand hygiene, movement in the surgery. Results: Cut the way caused the operating room infection, make the indicators of the operating room in the normal range, could avoid the occurrence of various surgical infections and improve the quality of health care. Conclusion: The effective implementations of the operating room disinfection and isolation measures were an important way to control hospital infection.%目的:解决手术室医院感染控制的难点并探讨手术室医院感染控制对策,以提高医疗护理质量.方法:通过我院感染管理科在日常工作中发现的问题,如手术室环境、无菌物品的管理、手卫生、手术中人员流动、各项感染措施及各项制度的落实等找出原因进行分析、整改和总结.结果:切断了引起手术室医院感染的途径,使手术室的各项指标在正常范围,避免了各项手术感染的发生,提高了医院的医疗护理质量.结论:有效地落实手术室消毒隔离措施是控制医院感染的重要途径.

  5. Rethinking theatre in modern operating rooms.

    Science.gov (United States)

    Riley, Robin; Manias, Elizabeth

    2005-03-01

    Metaphor is a means through which a widely accepted meaning of a word is used in a different context to add understanding that would otherwise be difficult to conceive. Through etymological and metaphorical associations, we contend that aspects of "theatre" are still relevant in the modern operating rooms and that the use of dramaturgical metaphors can add another layer of understanding about the social reality in this setting. We begin by exploring the historical roots and derivation of the word theatre as it applied to anatomical dissection and surgery. Briefly, we touch on the work of Erving Goffman and examine how his work has been used by others to explore aspects of operating room nursing. Then, drawing on data from a postmodern ethnographic study that has been used to examine communication in operating room nursing, four dramaturgical metaphors are used to illustrate the argument. They are drama, the script and learning the lines, the show must go on, and changing between back stage and front stage. To conclude, the small amount of previously published literature on this topic is compared and contrasted, and the relevance of using dramaturgical metaphors to understand modern operating rooms is discussed. Being able to distinguish between the inherent drama in operating room work and the dramatic realisation of individuals who work within, can help operating room nurses to think differently about, and perhaps re-evaluate their social situation and how they function within it.

  6. Operating Room Telephone Microbial Flora

    Science.gov (United States)

    2007-11-02

    beta-lactamase expressing multi-resistant Acinetobacter baumannii transmitted in the operation area. J Hosp Infect, 2004. 57(4): p. 308-15. 63...Goodman, J. E., Volk, H. M., and Sood, R., Direct costs of multidrug-resistant Acinetobacter baumannii in the burn unit of a public teaching hospital...Scerpella, E.G., Wanger, A. R., Armitige, L., Anderlini, P., & Ericsson, C. D., Nosocomial outbreak caused by a multiresistant clone of Acinetobacter

  7. Leap Motion Gesture Control With Carestream Software in the Operating Room to Control Imaging: Installation Guide and Discussion.

    Science.gov (United States)

    Pauchot, Julien; Di Tommaso, Laetitia; Lounis, Ahmed; Benassarou, Mourad; Mathieu, Pierre; Bernot, Dominique; Aubry, Sébastien

    2015-12-01

    Nowadays, routine cross-sectional imaging viewing during a surgical procedure requires physical contact with an interface (mouse or touch-sensitive screen). Such contact risks exposure to aseptic conditions and causes loss of time. Devices such as the recently introduced Leap Motion (Leap Motion Society, San Francisco, CA), which enables interaction with the computer without any physical contact, are of wide interest in the field of surgery, but configuration and ergonomics are key challenges for the practitioner, imaging software, and surgical environment. This article aims to suggest an easy configuration of Leap Motion on a PC for optimized use with Carestream Vue PACS v11.3.4 (Carestream Health, Inc, Rochester, NY) using a plug-in (to download at https://drive.google.com/open?id=0B_F4eBeBQc3yNENvTXlnY09qS00&authuser=0) and a video tutorial (https://www.youtube.com/watch?v=yVPTgxg-SIk). Videos of surgical procedure and discussion about innovative gesture control technology and its various configurations are provided in this article.

  8. HEMATOLOGIC FINDINGS IN OPERATING ROOM STAFFS

    Directory of Open Access Journals (Sweden)

    H SOLTANI

    2000-03-01

    Full Text Available Introduction. Long term exposure to trace amounts of anesthetic vapors and gases may produce hematologic and hepatic disorders in human. Since operating room (OR staffs are exposed to these agents, we decided to study their hematopoietic and hepatic systems in comparison with ordinary ward staffs. Methods. Seventy staffs from OR were compared with a matched similar number of ward staffs about their hematologic and hepatic laboratory findings in a historical cohort study. Findings. Mean of leukocyte and platelet counts were significantly lower in OR staffs, but in normal range. Mean of monocyte count was significantly higher in OR staffs. No significant differences were found between two groups for other hepatic and hematologic tests. Fatigue and headache were reported in OR staffs more than others. Conclusion. These findings may warn a risk to OR staffs but, it is not clear and requires further controlled studies.

  9. Implementing an operating room pharmacy satellite.

    Science.gov (United States)

    Powell, P J; Maland, L; Bair, J N; McCall, J D; Wong, K C

    1983-07-01

    Implementation of an operating room (OR) pharmacy satellite is described, and its impact on cost-effectiveness and efficiency of drug distribution is analyzed. The OR satellite provided pharmacy coverage for 30-35 patients per day in 10 centralized surgical suites, 2 obstetric suites, and 1 burn-unit suite in a 401-bed teaching hospital. Objectives of the satellite were to consolidate accountability for drug distribution and control, reduce controlled substance loss and waste, reduce inventory costs, and improve recording of patient charges. Stock on the OR supply cart was reduced, controlled substances were dispensed to anesthesiologists from the satellite, and a system of standardized anesthesiology exchange trays was developed. A new billing form served as both the charging document and replacement list. Reduction in the medication cart stock resulted in smaller discrepancies in patient charges. For the five most commonly used controlled substances, accounting discrepancies were reduced. Inventory turnover increased and inventory dollar value and cost per patient were reduced. The percent of nurses who believed that a pharmacist should work in the area increased from 31% before implementation of the satellite to 95% after. The pilot OR pharmacy satellite was a financial success. Efficiency and effectiveness in drug distribution and control were improved, and communication between pharmacists and other medical personnel working in the OR areas was enhanced.

  10. Design and Implementation of Air Conditioning System in Operating Room

    Directory of Open Access Journals (Sweden)

    Htet Htet Aung

    2014-10-01

    Full Text Available The system is air conditioning system in operating room. The main objective of the system was implemented to provide air balance and temperature necessary conditions and to control airflow system for ventilation units in operating room. The operation room can be controlled with fuzzy expert system and describes the desired outputs. Input parameters such as temperature, humidity, oxygen and particle are used and output parameters are chosen as air conditioning motor speed and exhaust motor speed. Input parameters of the system are taken into account optimal conditions based on oxygen as medium and other parameters are chosen minimum condition for operating room. The airflow control system is determined the two components: the airflow block and the thermal block for ventilation units in operating room. The mathematical modeling of each such system based on a computational procedure and to combine them together in an efficient manner. Whether it supports to the most suitable control for the system prototype was determined by simulating the operation with varying the number of personnel and duration of time. Finally, according to the combination of temperature and airflow regulations with PI controller, the results of simulation of the entire ventilation unit control system is obtained.

  11. Topical hemostasis: a valuable adjunct to control bleeding in the operating room, with a special focus on thrombin and fibrin sealants.

    Science.gov (United States)

    Doria, Cataldo; Vaccino, Silvia

    2009-02-01

    Achieving surgical hemostasis plays a major role in the operating room. Occasionally, classical surgical techniques are ill suited or fail to achieve the desired control at the site of bleeding. Topical hemostasis may be seen as a useful addition to assist the surgeon in controlling surgical bleeding. To provide a brief overview of available topical hemostatic agents with a focus on the different formulations of thrombin. The scope of the review was limited to a keyword search on PubMed and Ovid (surgical hemostasis, thrombin, tissue adhesives). Proven as adjuncts to surgical hemostasis, topical hemostatic agents have become quite valuable to bridge or to achieve permanent hemostasis.

  12. Operating room discharge after deep neuromuscular block reversed with sugammadex compared with shallow block reversed with neostigmine: a randomized controlled trial.

    Science.gov (United States)

    Putz, Laurie; Dransart, Christophe; Jamart, Jacques; Marotta, Maria-Laura; Delnooz, Geraldine; Dubois, Philippe E

    2016-12-01

    To determine if reversing a deep or moderate block with sugammadex, compared with a shallow block reversed with neostigmine, reduces the time to operating room discharge after surgery and the time spent in the postanesthesia care unit. A randomized controlled trial. Monocentric study performed from February 2011 until May 2012. One hundred consenting women with American Society of Anesthesiologists grade I or II were randomized into 2 groups. Laparoscopic hysterectomy was performed under desflurane general anesthesia. For the neostigmine (N) group, 0.45 mg · kg(-1) rocuronium was followed by spontaneous recovery. A 5-mg rescue bolus was administered only if surgical evaluation was unacceptable. At the end of surgery, 50 μg · kg(-1) neostigmine with glycopyrrolate was administered. For the sugammadex (S) group, a higher intubating rocuronium dose (0.6 mg · kg(-1)) was followed by 5-mg boluses each time the train-of-four count exceeded 2. Sugammadex (2-4 mg · kg(-1)) was administered to reverse the block. All patients were extubated after obtaining a train-of-four ratio of 0.9. The duration between the end of surgery and operating room discharge and the time spent in the postanesthesia care unit. The time till operating room discharge was shorter and more predictable in group S (9.15±4.28 minutes vs 13.87±11.43 minutes in group N; P=.005). The maximal duration in group S was 22 minutes, compared with 72 minutes in group N. The time spent in the postanesthesia care unit was not significantly different (group S: 47.75±31.77 minutes and group N: 53.43±40.57 minutes; P=.543). Maintaining a deep neuromuscular block during laparoscopic hysterectomy reversed at the end of the procedure with sugammadex enabled a faster and more predictable time till operating room discharge than did the classical combination of a shallower block reversed with neostigmine. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. [Comprehensive system integration and networking in operating rooms].

    Science.gov (United States)

    Feußner, H; Ostler, D; Kohn, N; Vogel, T; Wilhelm, D; Koller, S; Kranzfelder, M

    2016-12-01

    A comprehensive surveillance and control system integrating all devices and functions is a precondition for realization of the operating room of the future. Multiple proprietary integrated operation room systems are currently available with a central user interface; however, they only cover a relatively small part of all functionalities. Internationally, there are at least three different initiatives to promote a comprehensive systems integration and networking in the operating room: the Japanese smart cyber operating theater (SCOT), the American medical device plug-and-play interoperability program (MDPnP) and the German secure and dynamic networking in operating room and hospital (OR.NET) project supported by the Federal Ministry of Education and Research. Within the framework of the internationally advanced OR.NET project, prototype solution approaches were realized, which make short-term and mid-term comprehensive data retrieval systems probable. An active and even autonomous control of the medical devices by the surveillance and control system (closed loop) is expected only in the long run due to strict regulatory barriers.

  14. Simulation and experimental studies of operators` decision styles and crew composition while using an ecological and traditional user interface for the control room of a nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Meshkati, N.; Buller, B.J.; Azadeh, M.A. [Univ. of Southern California, Los Angeles, CA (United States)

    1995-04-01

    The goal of this research is threefold: (1) use of the Skill-, Rule-, and Knowledge-based levels of cognitive control -- the SRK framework -- to develop an integrated information processing conceptual framework (for integration of workstation, job, and team design); (2) to evaluate the user interface component of this framework -- the Ecological display; and (3) to analyze the effect of operators` individual information processing behavior and decision styles on handling plant disturbances plus their performance on, and preference for, Traditional and Ecological user interfaces. A series of studies were conducted. In Part I, a computer simulation model and a mathematical model were developed. In Part II, an experiment was designed and conducted at the EBR-II plant of the Argonne National Laboratory-West in Idaho Falls, Idaho. It is concluded that: the integrated SRK-based information processing model for control room operations is superior to the conventional rule-based model; operators` individual decision styles and the combination of their styles play a significant role in effective handling of nuclear power plant disturbances; use of the Ecological interface results in significantly more accurate event diagnosis and recall of various plant parameters, faster response to plant transients, and higher ratings of subject preference; and operators` decision styles affect on both their performance and preference for the Ecological interface.

  15. The radiation dose dilemma in the hybrid operating room

    NARCIS (Netherlands)

    de Ruiter, QMB

    2016-01-01

    The of the hybrid Operation room (an operation room combined with advanced radiological X-ray equipment) is gaining popularity, as it is now the preferred room to perform (complex) endovascular aortic procedures. The fixed C-arms equipped in these rooms make it possible to gain very high image

  16. The radiation dose dilemma in the hybrid operating room

    NARCIS (Netherlands)

    de Ruiter, QMB

    2016-01-01

    The of the hybrid Operation room (an operation room combined with advanced radiological X-ray equipment) is gaining popularity, as it is now the preferred room to perform (complex) endovascular aortic procedures. The fixed C-arms equipped in these rooms make it possible to gain very high image quali

  17. Local anaesthesia outside the operating room.

    Science.gov (United States)

    Chan, S K; Karmakar, M K; Chui, P T

    2002-04-01

    An increasing number of minor surgical procedures are performed under local anaesthesia in clinical settings outside the operating room, where monitoring and resuscitation equipment--as well as personnel skilled in resuscitation--may not be readily available. Serious adverse effects and even fatalities may result from the use of local anaesthetic agents, arising from a variety of causes such as systemic toxicity, allergy, vasovagal syncope, and reaction to additives present in the local anaesthetic. This article briefly reviews the pharmacology of local anaesthetic agents, and describes various techniques commonly used for local anaesthesia, with special emphasis on safety. Clinical features of toxicity, and its differential diagnosis and management, are also discussed.

  18. Prepare to protect: Operating and maintaining a tornado safe room.

    Science.gov (United States)

    Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

    2017-06-01

    Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

  19. Surgical attire and the operating room: role in infection prevention.

    Science.gov (United States)

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.

  20. Flow analysis of airborne particles in a hospital operating room

    Science.gov (United States)

    Faeghi, Shiva; Lennerts, Kunibert

    2016-06-01

    Preventing airborne infections during a surgery has been always an important issue to deliver effective and high quality medical care to the patient. One of the important sources of infection is particles that are distributed through airborne routes. Factors influencing infection rates caused by airborne particles, among others, are efficient ventilation and the arrangement of surgical facilities inside the operating room. The paper studies the ventilation airflow pattern in an operating room in a hospital located in Tehran, Iran, and seeks to find the efficient configurations with respect to the ventilation system and layout of facilities. This study uses computational fluid dynamics (CFD) and investigates the effects of different inflow velocities for inlets, two pressurization scenarios (equal and excess pressure) and two arrangements of surgical facilities in room while the door is completely open. The results show that system does not perform adequately when the door is open in the operating room under the current conditions, and excess pressure adjustments should be employed to achieve efficient results. The findings of this research can be discussed in the context of design and controlling of the ventilation facilities of operating rooms.

  1. A Development Method of Mobile Computerized Procedure System for the Cooperation among Field Workers and Main Control Room Operators in Korean Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Jin; Seong, No Kyu; Jung, Yeon Sub [KHNP ,Daejeon (Korea, Republic of)

    2014-08-15

    Human errors can occur during the test and maintenance of steam generator, safety injection system and other various systems and devices in nuclear power plants (NPPs). Most of human errors can be improved by the human error prevention techniques such as self-check, peer-check, concurrent verification and etc. Another important technique is to share work information among main control room (MCR) operators and field workers. Various field service automation tools have been developed with recent information technology in many countries. APR1400 computerized procedure system (CPS) has been developed for the MCR operators of Shin-Kori 3 and 4 units. Especially, the concurrent verification support design is applied in the construction project of Shin-Hanul 1 and 2 CPS. It is expected that the proposed mobile CPS can enhance the reduction of human errors by supporting human error prevention techniques and information sharing. This paper describes the technical issues of the mobile CPS (mobile CPS) in the initial development stage. Based on the design of APR1400, CRI CPS has been developed and operated for SKN 3 and 4 HFE V and V and license test for the MCR operating staff. Therefore the mobile CPS will be developed by upgrading the CRI CPS with improved features.

  2. Design of the control room of the N4-type PWR: main features and feedback operating experience; La salle de commande du palier N4: principales caracteristiques et retour d'experience d'exploitation

    Energy Technology Data Exchange (ETDEWEB)

    Peyrouton, J.M.; Guillas, J.; Nougaret, Ch. [Electricite de France (EDF/DPN/CAPE), 93 - Saint-Denis (France)

    2004-07-01

    This article presents the design, specificities and innovating features of the control room of the N4-type PWR. A brief description of control rooms of previous 900 MW and 1300 MW -type PWR allows us to assess the change. The design of the first control room dates back to 1972, at that time 2 considerations were taken into account: first the design has to be similar to that of control rooms for thermal plants because plant operators were satisfied with it and secondly the normal operating situation has to be privileged to the prejudice of accidental situations just as it was in a thermal plant. The turning point was the TMI accident that showed the weight of human factor in accidental situations in terms of pilot team, training, procedures and the ergonomics of the work station. The impact of TMI can be seen in the design of 1300 MW-type PWR. In the beginning of the eighties EDF decided to launch a study for a complete overhaul of the control room concept, the aim was to continue reducing the human factor risk and to provide a better quality of piloting the plant in any situation. The result is the control room of the N4-type PWR. Today the cumulated feedback experience of N4 control rooms represents more than 20 years over a wide range of situations from normal to incidental, a survey shows that the N4 design has fulfilled its aims. (A.C.)

  3. Physician communication in the operating room.

    Science.gov (United States)

    Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

    2015-01-01

    In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education.

  4. Study of factors controlling exposure dose and image quality of C-arm in operation room according to detector size of it (Mainly L-Spine AP study)

    Energy Technology Data Exchange (ETDEWEB)

    Chui, Sung Hyun; Jo, Hwang Woo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Chun, Woon Kwan; Song, Ha Jin [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Choi, Eun Jin [Dept. of Public Health and Medicine, Dongshin University, Naju (Korea, Republic of)

    2015-02-15

    Time of operation has been reduced and accuracy of operation has been improved since C-arm, which offer real-time image of patient, was introduced in operation room. However, because of the contamination of patient, C-arm could not be used more appropriately. Therefore, this study is to know factors of controlling exposure dose, image quality and the exposed dose of health professional in operation room. Height of Wilson frame (bed for operation) was fixed at 130 cm. Then, Model 76-2 Phantom, which was set by assembling manual of Fluke Company, was set on the bed. Head/Spine Fluoroscopy AEC mode was set for exposure condition. According to detector size of C-arm, the absorbed dose per min was measured in the 7 steps OFD (cm) from 10 cm to 40 cm (10, 15, 20, 25, 30, 35, 40 cm). In each step of OFD, the absorbed dose per min of same diameter of collimation was measured. Moreover, using Nero MAX Model 8000, exposure dose per min was measured according to 3 step of distance from detector (20 cm, 60 cm, 100 cm). Finally, resolution was measured by CDRH Disc Phantom and magnification of each OFD was measured by aluminum stick bar. According to detector size of C-arm, difference of absorbed dose shows that the dose of 20 cm OFD is 1.750 times higher than the dose of 40 cm OFD. It means that the C-arm, which has smaller size of detector, shows the bigger difference of absorbed dose per min (p<0.05). In the difference of absorbed dose in the same step of OFD (from 20 cm to 40 cm), the absorbed dose of 9 inch detect or C-arm was 1.370 times higher than 12 inch' s (p<0.05). When OFD was set to 20 cm OFD, the absorbed dose of non-collimation case was approximately 0.816 times lower than the absorbed dose of collimation cases (p<0.05). When the distance was 20 cm from detector, exposed does includes first-ray and scatter-ray. When the distance was 60 cm and 100 cm from detector, exposed does includes just scatter-ray. So, there was the 2.200 times difference of absorbed

  5. Key requirements for future control room functionality

    DEFF Research Database (Denmark)

    Tornelli, Carlo; Zuelli, Roberto; Marinelli, Mattia

    2016-01-01

    This internal report provides the key requirements for the future control centres. R8.1 represents the starting point of WP8 activities and wants to achieve a double objective. On the one hand it collects general requirements on future control centres emerging from the general trends in power...... system operation as well as experiences and results from other European projects. On the other hand, it analyses what requirements for future control rooms arise from the ELECTRA proposed control solutions. Hence, different points of view are taken into account. The ELECTRA Use Cases (UCs...... requirements for the future control centres discussed within this report. The analysis of what happened before the European system disturbance occurred on 4th November 2006 and of the existing trends by vendors helped T8.1 in the definition of the requirements for the future control centres. Volunteer...

  6. Recent Development in the ATLAS Control Room

    CERN Multimedia

    Armen Vartapetian

    Only recently the name ATLAS Control Room (ACR) was more associated with the building at Point 1 (SCX1) than with the real thing. But just within the last several months, with the installation of the ACR hardware, that perception has changed significantly. The recently furnished ATLAS control room. But first of all, if you are not familiar with the ATLAS experimental site and are interested in visiting the ATLAS control room to see the place that in the near future will become the brain of the detector operations, it is quite easy to do so. You don't even need safety helmet or shoes! The ACR is located on the ground floor of a not so typical, glass-covered building in Point 1. The building number on the CERN map is 3162, or SCX1 as we call it. It is also easy to recognize that building by its shiny appearance within the cluster of Point 1 buildings if you are driving from Geneva. Final design and prototyping of the ACR hardware started at the beginning of 2006. Evaluation of the chosen hardware confi...

  7. Door Opening Affects Operating Room Pressure During Joint Arthroplasty.

    Science.gov (United States)

    Mears, Simon C; Blanding, Renee; Belkoff, Stephen M

    2015-11-01

    Many resources are expended to ensure a sterile operating room environment. Efforts are made to prevent exposure of patients to personnel and to achieve positive room pressure to keep out airborne contaminants. Foot traffic into and out of the operating room during surgery can undermine these efforts. The authors investigated the number and duration of operating room door openings during hip and knee arthroplasty procedures and the effect of the door openings on room pressure. They tested the hypothesis that door openings defeat positive pressure, permitting air flow into the room. Room pressure and door status were monitored electronically during 191 hip and knee arthroplasty procedures. Operating room staff were unaware that data were being collected. The authors evaluated the data with regression analysis to determine whether the number and duration of door openings had an effect on room pressure. Significance was set at Poperating room. Total time with the door open significantly affected the minimum pressure recorded in the room (Poperating room sterility. The causes of excessive operating room traffic must be evaluated to identify ways to reduce this traffic and the associated risks.

  8. Surgical site infection prevention: the operating room environment.

    Science.gov (United States)

    Clyburn, Terry A; Evans, Richard P; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Surgical site infections can complicate orthopaedic procedures and contribute to morbidity, mortality, and health care costs. Extensive literature has been published on this topic; however, the quality of data using standards of evidence-based medicine is variable with a lack of well-controlled studies. A review of the literature concerning measures to prevent surgical site infections in the operating room environment may be helpful in preventing such infections.

  9. Using a Research Simulator for Validating Control Room Modernization Concepts

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring; Vivek Agarwal; Julius J. Persensky; Jeffrey C. Joe

    2012-05-01

    The Light Water Reactor Sustainability Program is a research, development, and deployment program sponsored by the United States Department of Energy. The program is operated in close collaboration with industry research and development programs to provide the technical foundations for licensing and managing the long-term, safe, and economical operation of nuclear power plants that are currently in operation. Advanced instrumentation and control (I&C) technologies are needed to support the continued safe and reliable production of power from nuclear energy systems during sustained periods of operation up to and beyond their expected licensed lifetime. This requires that new capabilities to achieve process control be developed and eventually implemented in existing nuclear control rooms. It also requires that approaches be developed and proven to achieve sustainability of I&C systems throughout the period of extended operation. Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe life extension of current reactors. One of the main areas of focus is control room modernization. Current analog control rooms are growing obsolete, and it is difficult for utilities to maintain them. Using its reconfigurable control room simulator adapted from a training simulator, INL serves as a neutral test bed for implementing new control room system technologies and assisting in control room modernization efforts across.

  10. Workplace culture among operating room nurses.

    Science.gov (United States)

    Eskola, Suvi; Roos, Mervi; McCormack, Brendan; Slater, Paul; Hahtela, Nina; Suominen, Tarja

    2016-09-01

    To investigate the workplace culture in the Operating Room (OR) environment and the factors associated with it. In health care, the workplace culture affects the delivery and experience of care. The OR can be a stressful practice environment, where nurses might have occasionally either job stress or job satisfaction based on their competence. A quantitative cross-sectional approach was used. The study consisted of 96 Finnish OR nurses. A Nursing Context Index instrument was used to obtain data by way of an electronic questionnaire. The primary role and working unit of respondents were the main components relating to workplace culture, and especially to job stress. Nurse anaesthetists were found to be slightly more stressed than scrub nurses. In local hospitals, job stress related to workload was perceived less than in university hospitals (P = 0.001). In addition, OR nurses in local hospitals were more satisfied with their profession (P = 0.007), particularly around issues concerning adequate staffing and resources (P = 0.001). It is essential that nurse managers learn to recognise the different expressions of workplace culture. In particular, this study raises a need to recognise the factors that cause job stress to nurse anaesthetists. © 2016 John Wiley & Sons Ltd.

  11. Safety status system for operating room devices.

    Science.gov (United States)

    Guédon, Annetje C P; Wauben, Linda S G L; Overvelde, Marlies; Blok, Joleen H; van der Elst, Maarten; Dankelman, Jenny; van den Dobbelsteen, John J

    2014-01-01

    Since the increase of the number of technological aids in the operating room (OR), equipment-related incidents have come to be a common kind of adverse events. This underlines the importance of adequate equipment management to improve the safety in the OR. A system was developed to monitor the safety status (periodic maintenance and registered malfunctions) of OR devices and to facilitate the notification of malfunctions. The objective was to assess whether the system is suitable for use in an busy OR setting and to analyse its effect on the notification of malfunctions. The system checks automatically the safety status of OR devices through constant communication with the technical facility management system, informs the OR staff real-time and facilitates notification of malfunctions. The system was tested for a pilot period of six months in four ORs of a Dutch teaching hospital and 17 users were interviewed on the usability of the system. The users provided positive feedback on the usability. For 86.6% of total time, the localisation of OR devices was accurate. 62 malfunctions of OR devices were reported, an increase of 12 notifications compared to the previous year. The safety status system was suitable for an OR complex, both from a usability and technical point of view, and an increase of reported malfunctions was observed. The system eases monitoring the safety status of equipment and is a promising tool to improve the safety related to OR devices.

  12. [Design, equipment, and management for air conditioning in operating room].

    Science.gov (United States)

    Fuji, Kumiko; Mizuno, Ju

    2011-11-01

    In order to maintain air cleanliness in the operating room (OR) permanently, air exchange rate in the OR should be more than 15 times x hr(-1), the laminar air flow should be kept, and the numbers of the persons in the OR and the numbers of opening and closing OR door should be limited. High efficiency particulate air (HEPA) filter is effective in collection and removal of airborne microbes, and is used in the biological clean room. We need to design, equip, and manage the OR environment according to Guideline for Design and Operation of Hospital HVAC Systems HEAS-02-2004 established by Healthcare Engineering Association of Japan and Guideline for Prevention of Surgical Site Infection (SSI) established by the Center for Disease Control and Prevention (CDC) in the USA.

  13. Psychological and Physical Stress in Surgeons Operating in a Standard or Modern Operating Room

    DEFF Research Database (Denmark)

    Klein, M.; Andersen, L.P.H.; Gögenür, Ismayil

    2010-01-01

    Purpose: There have been no studies examining the effect of optimized ergonomic and technical environment on the psychological and physiological stress of the surgeon. The aim of this study was to examine whether optimized ergonomics and technical aids within a modern operating room (OR) affect...... psychological and physiological stress in experienced laparoscopic surgeons. Methods: This was a prospective case-controlled study including 10 experienced surgeons. Surgery was performed in 2 different ORs: a standard room and a modern room (OR1-suite, Karl Storz). The surgeons filled out questionnaires...

  14. A Learning Needs Assessment of Operating Room Nurses.

    Science.gov (United States)

    Pounds, Elizabeth; Littlefield, John H.

    Operating room nursing is not a formal part of the generic nursing curriculum. A learning needs assessment can serve to identify inservice education needs of operating nurses. In this study, a factor analysis was performed on the responses of 1,201 practicing operating room nurses to a list of 24 behaviorally-stated learning needs. Four factors,…

  15. Development of digital device based work verification system for cooperation between main control room operators and field workers in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Min, E-mail: jewellee@kaeri.re.kr [Korea Atomic Energy Research Institute, 305-353, 989-111 Daedeok-daero, Yuseong-gu, Daejeon (Korea, Republic of); Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Lee, Hyun Chul, E-mail: leehc@kaeri.re.kr [Korea Atomic Energy Research Institute, 305-353, 989-111 Daedeok-daero, Yuseong-gu, Daejeon (Korea, Republic of); Ha, Jun Su, E-mail: junsu.ha@kustar.ac.ae [Department of Nuclear Engineering, Khalifa University of Science Technology and Research, Abu Dhabi P.O. Box 127788 (United Arab Emirates); Seong, Poong Hyun, E-mail: phseong@kaist.ac.kr [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon 305-701 (Korea, Republic of)

    2016-10-15

    Highlights: • A digital device-based work verification and cooperation support system was developed. • Requirements were derived by interviewing field operators having experiences with mobile-based work support systems. • The usability of the proposed system was validated by conducting questionnaire surveys. • The proposed system will be useful if the manual or the set of guidelines is well constructed. - Abstract: Digital technologies have been applied in the nuclear field to check task results, monitor events and accidents, and transmit/receive data. The results of using digital devices have proven that these devices can provide high accuracy and convenience for workers, allowing them to obtain obvious positive effects by reducing their workloads. In this study, as one step forward, a digital device-based cooperation support system, the nuclear cooperation support and mobile documentation system (Nu-COSMOS), is proposed to support communication between main control room (MCR) operators and field workers by verifying field workers’ work results in nuclear power plants (NPPs). The proposed system consists of a mobile based information storage system to support field workers by providing various functions to make workers more trusted by MCR operators; also to improve the efficiency of meeting, and a large screen based information sharing system supports meetings by allowing both sides to share one medium. The usability of this system was estimated by interviewing field operators working in nuclear power plants and experts who have experience working as operators. A survey to estimate the usability of the suggested system and the suitability of the functions of the system for field working was conducted for 35 subjects who have experience in field works or with support system development-related research. The usability test was conducted using the system usability scale (SUS), which is widely used in industrial usability evaluation. Using questionnaires

  16. Foucault could have been an operating room nurse.

    Science.gov (United States)

    Riley, Robin; Manias, Elizabeth

    2002-08-01

    Operating room nursing is an under-researched area of nursing practice. The stereotypical image of operating room nursing is one of task- and technically-orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in-depth analysis of this specialty area of practice. The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the 'surgical conscience'. This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.

  17. Attitudes and behavior towards patient safety in an operating room

    Directory of Open Access Journals (Sweden)

    María del Pilar Sánchez Moreno

    2013-09-01

    Full Text Available Patient´s safety is a priority line of action in the Quality of Health Care. Adequate patient safety culture is one of the important pillars in the health care. Also the World Health Organization reports that 7 million people, of 234 million of major surgeries, suffer complications and this can be reduced by half with a system that decreases the possibility of error. Objectives: To determinate the attitude and behavior of professionals in the operating room unit in Hospital Virgen de la Salud of Toledo towards patient safety. Material and method: The type of study is a descriptive and transversal. Population: medical and nursing staff of the theatre with over 1 year in service. Measurement of variables will be made by a validated test and adapted to Spanish territory by the Agency for Healthcare Research and Quality of the United States. We intend to identify the strengths and weaknesses in matter of operating room safety, to know the starting point for the implementation of the surgical safety checklist and to develop a safety culture in the operating room with standardized tools and regular quality controls.

  18. Noise control considerations for patient rooms

    Science.gov (United States)

    Davenny, Benjamin

    2005-09-01

    The patient room envelope is a path between outside noise sources and the patient receiver. Within the patient room there are several sources including televisions, clinical monitor alarms, medical pumps, etc. Noise control in patient rooms relies on a combination of the sound transmission loss of the patient room envelope and the level of background sound at the patient's head. Guidelines published by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), American Institute of Architects (AIA), and the U.S. Department of Defense for background noise and sound transmission loss in patient rooms will be discussed. Appropriate levels, spectra, and temporal characteristics of background sound at the patient head location may be helpful in raising the threshold of annoying sounds. Various means of personal hearing protection for patients will be discussed. Sound-pressure levels in patient rooms reported in previous literature will also be discussed.

  19. Evaporation Controlled Emission in Ventilated Rooms

    DEFF Research Database (Denmark)

    Topp, Claus; Nielsen, Peter V.; Heiselberg, Per

    -scale ventilated room when the emission is fully or partly evaporation controlled. The objective of the present research work has been to investigate the change of emission rates from small-scale experiments to full-scale ventilated rooms and to investigate the influence of the local air velocity field near...

  20. The Patient Safety Attitudes among the Operating Room Personnel

    Directory of Open Access Journals (Sweden)

    Cherdsak Iramaneerat

    2016-07-01

    Full Text Available Background: The first step in cultivating the culture of safety in the operating room is the assessment of safety culture among operating room personnel. Objective: To assess the patient safety culture of operating room personnel at the Department of Surgery, Faculty of Medicine Siriraj Hospital, and compare attitudes among different groups of personnel, and compare them with the international standards. Methods: We conducted a cross-sectional survey of safety attitudes among 396 operating room personnel, using a short form of the Safety Attitudes Questionnaire (SAQ. The SAQ employed 30 items to assess safety culture in six dimensions: teamwork climate, safety climate, stress recognition, perception of hospital management, working conditions, and job satisfaction. The subscore of each dimension was calculated and converted to a scale score with a full score of 100, where higher scores indicated better safety attitudes. Results: The response rate was 66.4%. The overall safety culture score of the operating room personnel was 65.02, higher than an international average (61.80. Operating room personnel at Siriraj Hospital had safety attitudes in teamwork climate, safety climate, and stress recognition lower than the international average, but had safety attitudes in the perception of hospital management, working conditions, and job satisfaction higher than the international average. Conclusion: The safety culture attitudes of operating room personnel at the Department of Surgery, Siriraj Hospital were comparable to international standards. The safety dimensions that Siriraj Hospital operating room should try to improve were teamwork climate, safety climate, and stress recognition.

  1. A model for generating master surgical schedules to allow cyclic scheduling in operating room departments

    NARCIS (Netherlands)

    Oostrum, van J.M.; Houdenhoven, van M.; Hurink, J.L.; Hans, E.W.; Wullink, G.; Kazemier, G.

    2005-01-01

    This paper addresses the problem of operating room scheduling at the tactical level of hospital planning and control. Hospitals repetitively construct operating room schedules, which is a time consuming tedious and complex task. The stochasticity of the durations of surgical procedures complicates t

  2. Disinfection and sterilization monitoring and hospital infection control in operating room%手术室消毒灭菌监测与医院感染控制

    Institute of Scientific and Technical Information of China (English)

    唐香祝; 阮杏菲; 江翠波

    2016-01-01

    目的:探讨加强手术室消毒灭菌监测,对医院感染控制的作用。方法根据《消毒技术规范》中所规定的操作要求对手术室消毒灭菌效果进行监测。研究采用回顾性及现场临床观察方法,观察患者术后伤口情况。结果实施手术室消毒灭菌监测前,空气灭菌合格率、消毒物品灭菌合格率、医护人员手灭菌合格率分别为92.63%、93.75%、88.57%,实施手术室消毒灭菌监测后,空气灭菌合格率、消毒物品灭菌合格率、医护人员手灭菌合格率分别为98.96%、100.00%、100.00%,差异有统计学意义(P<0.05);实施手术室消毒灭菌监测前,手术患者切口感染率为6.41%,Ⅰ类切口感染率、Ⅱ类切口感染率、Ⅲ类切口感染率分别为2.54%、6.22%、11.34%,实施手术室消毒灭菌监测后,手术患者切口感染率为2.57%,Ⅰ类切口感染率、Ⅱ类切口感染率、Ⅲ类切口感染率分别为0.39%、2.21%、5.77%,差异有统计学意义(P<0.05)。结论通过手术室消毒灭菌监测,能够有效提高手术室内空气、设备、器械等灭菌率。此外,还能够有效降低手术患者术后切口感染率,值得推广。%Objective To study the effect of disinfection and sterilization monitoring and hospital infection control in operating room.MethodsTo monitor the effect of disinfection and sterilization in operating room according to the operation requirements stipulate by disinfection technical guidelines.To observe the patients' postoperative wound condition according to the methods of retrospectively study and spot clinical observation.Results The differences of the eligible sterilization rate of air, disinfection materials, hands of medical staff after implementation of disinfection and sterilization monitoring(98.96%,100.00%,100.00%)were statically significant compared with which before implementation of disinfection and sterilization monitoring(92

  3. Virtual Training of Compressor Control Room Project

    Data.gov (United States)

    National Aeronautics and Space Administration — MYMIC will analyze, design, develop and evaluate the Virtual Control Room – Compressor Station (VCoR-CS) training system. VCoR-CS will provide procedural...

  4. Effective management strategy for establishing an operating room satellite pharmacy.

    Science.gov (United States)

    Brakebill, J I; Schoeneman, P F; Buchanan, B

    1988-11-01

    The steps involved in justifying and implementing an operating room (OR) pharmacy satellite are described. A hospital administrator's viewpoint on the project is included. Objectives of the satellite were to reduce inventory costs, improve control of distribution, reduce loss of revenue and improve patient charging, improve IV compounding and labeling, and significantly improve narcotic control and accountability. The satellite provides comprehensive services 12 hours a day, five days a week. Effective after-hours procedures have been developed to provide efficient drug distribution when the pharmacy is closed. Achieved benefits of the satellite include decreased drug inventory, improved patient charging, accurate labeling, improved IV compounding, and improved pharmacy/surgery relations. The OR pharmacy satellite is a successful cost-effective operation.

  5. 加强医院整形美容门诊手术室管理控制医院感染%Improving management of cosmetic surgery outpatient operating room to control nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    王艳; 董薪; 张金凤; 孙建荷

    2011-01-01

    目的 探讨医院整形美容门诊手术室安全有效的管理措施,加强整形美容手术各个环节管理,预防和控制医院感染. 方法 通过加强组织领导,规范手术室环境、手术物品、手术人员等各个环节管理, 建立健全整形美容手术室医院感染控制体系. 结果 加强了整形美容手术室医院感染的管理体系,有效地预防和控制了医院感染,提高了手术室医疗护理质量. 结论 采取严格规范系统的整形美容手术管理措施,可以有效控制医院感染的发生,对加强医院规范化管理,控制医院感染具有积极重要的意义.%OBJECTIVE To discuss the effective measures for the safety of cosmetic surgery in outpatient operating room and strengthen the management of every links of cosmetic surgery to prevent and control the incidence of nosocomial infection. METHODS By means of reinforcing the administrative performance, the links to the operating room management, such as the environment of operating room, supervision of operation materials and surgical staff, were regulated to establish and perfect the control system of hospital infection in cosmetic surgery operating room. RESULTS The administrative system of nosocomial infection, the effective prevention and control of nosocomial infection in cosmetic surgery operation room and the quality of medical care in cosmetic surgery operation room had been improved. CONCLUSION Adopting the strict, standard and systemic management in cosmetic surgery can effectively control the occurrence of hospital infection and improve the quality of medical nursing and ensure the medical security, which has the positive significance to the standardized management and control of nosocomial infection.

  6. Diagnostic hysteroscopy in a procedure room setting compared to diagnostic hysteroscopy in the operating room

    Directory of Open Access Journals (Sweden)

    Ayman Oraif

    2016-12-01

    Conclusions: Diagnostic hysteroscopy is currently considered a valuable investigational tool for endometrial abnormalities and abnormal uterine bleeding. Most of these procedures can be performed in a procedure room setting without I.V. sedation or pre-operative narcotics. In our experience, a utero-sacral block using lidocaine is quite effective in controlling discomfort while passing various instruments through the internal cervical os. These techniques result in good visualization of the endometrial cavity, adequate and appropriate endometrial sampling with tolerable discomfort. The patients spend less time in the hospital, experience a much faster recovery and have less pre-operative restrictions. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4164-4173

  7. Information Foraging in Nuclear Power Plant Control Rooms

    Energy Technology Data Exchange (ETDEWEB)

    R.L. Boring

    2011-09-01

    nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators to appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.

  8. Influence of disturbances on bacteria level in an operating room

    DEFF Research Database (Denmark)

    Brohus, Henrik; Hyldig, Mikkel; Kamper, Simon

    2008-01-01

    In operating rooms great effort is manifested to reduce the bacteria level in order to decrease the risk of infections. The main source of bacteria is the staff and the patient, thus, the resulting bacteria concentration is roughly speaking a combination of the ventilation system and the emission...... from the occupants. This study investigates the influence of two main disturbances in an operating room namely the door opening during the operation and the activity level of the staff. It is found that the frequent door opening in this case does not cause significant transport of air from outside...... the operating room to the wound area of the patient. However, a significant influence of the activity level on the bacteria emission and concentration is found. Counting the number of persons in an operating room to estimate the bacteria source strength is not sufficient, the corresponding activity level must...

  9. Concentrations of methoxyflurane and nitrous oxide in veterinary operating rooms

    Energy Technology Data Exchange (ETDEWEB)

    Ward, G.S.; Byland, R.R.

    1982-02-01

    The surgical rooms of 14 private veterinary practices were monitored to determined methoxyflurane (MOF) concentrations during surgical procedure under routine working conditions. The average room volume for these 14 rooms was 29 m3. The average MOF value for all rooms was 2.3 ppm, with a range of 0.7 to 7.4 ppm. Four of the 14 rooms exceeded the maximum recommended concentration of 2 ppm. Six rooms which had 6 or more air changes/hr averaged 1.1 ppm, whereas 8 rooms with less than 6 measurable air changes/hr averaged 3.2 ppm. Operating rooms that had oxygen flows of more than 1,000 cm3/min averaged 4.4 ppm, whereas those with flows of less than 1,000 cm3/min averaged 1.5 ppm. The average time spent during a surgical procedure using MOF, for all 14 facilities, was 2 hours. Nitrous oxide (N/sub 2/O) concentrations were determined in 4 veterinary surgical rooms. The average N/sub 2/O concentration for 3 rooms without waste anesthetic gas scavenging was 138 ppm. Concentration of N/sub 2/O in the waste anesthetic gas-scavenged surgical room was 14 ppm, which was below the maximum recommended concentration of 25 ppm.

  10. Influence of behavior control on occupational exposure of operating room nurses%行为控制对手术室护士职业暴露的影响

    Institute of Scientific and Technical Information of China (English)

    林华; 余丽君; 袁慧

    2015-01-01

    目的:探讨行为控制对手术室护士职业暴露的影响。方法:统计我院2009年7月~2013年6月施行行为控制前后66名手术室护士在35767例手术配合过程中发生的职业暴露次数,比较行为控制对手术室护士职业暴露的影响。结果:行为控制前护士的职业暴露率为0.18%,采取行为控制后职业暴露率为0.06%。结论:行为控制能有效降低职业暴露对手术室护士的伤害,可以作为预防和减少职业暴露的方法在临床使用。%Objective:To investigate the behavioral control of occupational exposure to operating room nurses.Statistical methods in our hospital in July 2009 to June 2013 after 66 behavioral control purposes operating room nurse in 35,767 cases occur during surgery with occupational exposure times,more behav-ioral control on the impact of occupational exposure to operating room nurses.Results:Behavioral control former nurse occupational exposure was 0.18%,af-ter taking behavior control occupational exposure was 0.06%.Conclusion:Behavioral control can effectively reduce occupational exposure to operating room nurse injuries,can be used as prevention and reduction of occupational exposure in clinical.

  11. [Performance development of a university operating room after implementation of a central operating room management].

    Science.gov (United States)

    Waeschle, R M; Sliwa, B; Jipp, M; Pütz, H; Hinz, J; Bauer, M

    2016-08-01

    The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7.45 a.m. to 3.30 p.m. from 2009 to 2014. The achievement of process target times for the morning surgery start time and the turnover times of anesthesia and OR-nurses were calculated as indicators of process quality. The number of operations and cumulative incision-suture time were also analyzed as aggregated performance indicators. In order to assess the development of revenues in the operating theatre, the revenues from diagnosis-related groups (DRG) in all inpatient and occupational accident cases, adjusted for the regional basic case value from 2009, were calculated for each year. The development of revenues was also analyzed after deduction of revenues resulting from altered economic case weighting. It could be shown that the achievement of process target values for the morning surgery start time could be improved by 40 %, the turnover times for anesthesia reduced by 50 % and for the OR-nurses by 36 %. Together with the introduction of central planning for reallocation, an increase in operation numbers of 21 % and cumulative incision-suture times of 12% could be realized. Due to these additional operations the DRG revenues in 2014 could be increased to 132 % compared to 2009 or 127 % if the revenues caused by economic case weighting were excluded. The personnel complement in anesthesia (-1.7 %) and OR-nurses (+2.6 %) as well as anesthetists (+6.7 %) increased less compared to the

  12. Virtual reality in the operating room of the future.

    Science.gov (United States)

    Müller, W; Grosskopf, S; Hildebrand, A; Malkewitz, R; Ziegler, R

    1997-01-01

    In cooperation with the Max-Delbrück-Centrum/Robert-Rössle-Klinik (MDC/RRK) in Berlin, the Fraunhofer Institute for Computer Graphics is currently designing and developing a scenario for the operating room of the future. The goal of this project is to integrate new analysis, visualization and interaction tools in order to optimize and refine tumor diagnostics and therapy in combination with laser technology and remote stereoscopic video transfer. Hence, a human 3-D reference model is reconstructed using CT, MR, and anatomical cryosection images from the National Library of Medicine's Visible Human Project. Applying segmentation algorithms and surface-polygonization methods a 3-D representation is obtained. In addition, a "fly-through" the virtual patient is realized using 3-D input devices (data glove, tracking system, 6-DOF mouse). In this way, the surgeon can experience really new perspectives of the human anatomy. Moreover, using a virtual cutting plane any cut of the CT volume can be interactively placed and visualized in realtime. In conclusion, this project delivers visions for the application of effective visualization and VR systems. Commonly known as Virtual Prototyping and applied by the automotive industry long ago, this project shows, that the use of VR techniques can also prototype an operating room. After evaluating design and functionality of the virtual operating room, MDC plans to build real ORs in the near future. The use of VR techniques provides a more natural interface for the surgeon in the OR (e.g., controlling interactions by voice input). Besides preoperative planning future work will focus on supporting the surgeon in performing surgical interventions. An optimal synthesis of real and synthetic data, and the inclusion of visual, aural, and tactile senses in virtual environments can meet these requirements. This Augmented Reality could represent the environment for the surgeons of tomorrow.

  13. Controllability of room air temperature. Huonelaempoetilan saeaetoe

    Energy Technology Data Exchange (ETDEWEB)

    Laitila, P.; Katajisto, K.; Karjalainen, S.; Lassila, K. (Valtion Teknillinen Tutkimuskeskus, Espoo (Finland). LVI-tekniikan Laboratorio)

    1991-01-15

    At first, the control loop of room air temperature was studied as a unit process to find out the characteristic controllability factors of the process as well as possible. Step-response tests were made to the process. Furthermore, the choice of the control law, the adjustment of the controller parameters and the applicability of the controller parameters were analyzed. The results are based mainly on the simulation studies of the office building using the TRNSYS, HVACSIM{sup +} and PIPNET simulation programs. When making a step-change, e.g. to inlet air temperature, it takes a long time before the room air temperature achieves its final steady state. In addition, the gain of the process is slow. The time constant of the process is 30 min - 100 min. The steady state in terms of controllability is achieved in approximately four hours. The control difficulty of the process is significant below 0,1 independently of a heating or air conditioning system of the room space. The centralized and the distributed control of the room air temperature was studied as well. When the loads in different spaces differed greatly from one another, temperature conditions could not be controlled using centralized control. In that case the distributed temperature control based on room or zone space should be used. The integrated control of the air conditioning and heating systems proved to be quite difficult on the basis of the simulation studies especially when external loads vary a lot. The measurements made in a building in prevailing conditions did not support the integrated control of the air conditioning and heating systems. However, the heating system was under-dimensioned compared to the air conditioning system.

  14. FRAMEWORK AND APPLICATION FOR MODELING CONTROL ROOM CREW PERFORMANCE AT NUCLEAR POWER PLANTS

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L Boring; David I Gertman; Tuan Q Tran; Brian F Gore

    2008-09-01

    This paper summarizes an emerging project regarding the utilization of high-fidelity MIDAS simulations for visualizing and modeling control room crew performance at nuclear power plants. The key envisioned uses for MIDAS-based control room simulations are: (i) the estimation of human error associated with advanced control room equipment and configurations, (ii) the investigative determination of contributory cognitive factors for risk significant scenarios involving control room operating crews, and (iii) the certification of reduced staffing levels in advanced control rooms. It is proposed that MIDAS serves as a key component for the effective modeling of cognition, elements of situation awareness, and risk associated with human performance in next generation control rooms.

  15. [Patient safety recommendations for out of operating room procedure sedation].

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Patient safety recommendations for out of operating room procedure sedation.

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    2016-12-01

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Dedication instrumentation control rooms; Dedicacion instrumentacion salas de control

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, M. I.; Vilas, J. L.; Bravo, J. L.; Rejas, L.; Corrales, C.

    2013-07-01

    Tecnatom has participated since 2010 in the project, led by IOM (USA), design and supply of Control rooms of NPPS Chinese with CPR-1000 design. Among the various activities, the dedication of the components of the Control rooms (BUP - Back - up Panel and ECP - Emergency Control Panel) is joining the American requirements with the criteria of the French regulations.

  18. Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel.

    Science.gov (United States)

    Sexton, J Bryan; Makary, Martin A; Tersigni, Anthony R; Pryor, David; Hendrich, Ann; Thomas, Eric J; Holzmueller, Christine G; Knight, Andrew P; Wu, Yun; Pronovost, Peter J

    2006-11-01

    The Joint Commission on Accreditation of Healthcare Organizations is proposing that hospitals measure culture beginning in 2007. However, a reliable and widely used measurement tool for the operating room (OR) setting does not currently exist. OR personnel in 60 US hospitals were surveyed using the Safety Attitudes Questionnaire. The teamwork climate domain of the survey uses six items about difficulty speaking up, conflict resolution, physician-nurse collaboration, feeling supported by others, asking questions, and heeding nurse input. To justify grouping individual-level responses to a single score at each hospital OR level, the authors used a multilevel confirmatory factor analysis, intraclass correlations, within-group interrater reliability, and Cronbach's alpha. To detect differences at the hospital OR level and by caregiver type, the authors used multivariate analysis of variance (items) and analysis of variance (scale). The response rate was 77.1%. There was robust evidence for grouping individual-level respondents to the hospital OR level using the diverse set of statistical tests, e.g., Comparative Fit Index = 0.99, root mean squared error of approximation = 0.05, and acceptable intraclasss correlations, within-group interrater reliability values, and Cronbach's alpha = 0.79. Teamwork climate differed significantly by hospital (F59, 1,911 = 4.06, P teamwork climate is possible using this psychometrically sound teamwork climate scale. This tool and initial benchmarks allow others to compare their teamwork climate to national means, in an effort to focus more on what excellent surgical teams do well.

  19. Improving operating room turnover time: a systems based approach.

    Science.gov (United States)

    Bhatt, Ankeet S; Carlson, Grant W; Deckers, Peter J

    2014-12-01

    Operating room (OR) turnover time (TT) has a broad and significant impact on hospital administrators, providers, staff and patients. Our objective was to identify current problems in TT management and implement a consistent, reproducible process to reduce average TT and process variability. Initial observations of TT were made to document the existing process at a 511 bed, 24 OR, academic medical center. Three control groups, including one consisting of Orthopedic and Vascular Surgery, were used to limit potential confounders such as case acuity/duration and equipment needs. A redesigned process based on observed issues, focusing on a horizontally structured, systems-based approach has three major interventions: developing consistent criteria for OR readiness, utilizing parallel processing for patient and room readiness, and enhancing perioperative communication. Process redesign was implemented in Orthopedics and Vascular Surgery. Comparisons of mean and standard deviation of TT were made using an independent 2-tailed t-test. Using all surgical specialties as controls (n = 237), mean TT (hh:mm:ss) was reduced by 0:20:48 min (95 % CI, 0:10:46-0:30:50), from 0:44:23 to 0:23:25, a 46.9 % reduction. Standard deviation of TT was reduced by 0:10:32 min, from 0:16:24 to 0:05:52 and frequency of TT≥30 min was reduced from 72.5to 11.7 %. P systems-based focus should drive OR TT design.

  20. Before operating room nursing journals: operating room nursing in the pages of the Canadian Nurse 1940-1960.

    Science.gov (United States)

    Moszczynski, Alice

    2010-09-01

    The Canadian Nurses Association (CNA) values learning from nursing history to provide a contextual perspective in understanding how past events have shaped current nursing practice. Until the publication of operating room nursing journals, Canada's national nursing journal, The Canadian Nurse, served as an educational and professional resource for those nurses working in the operating room and for nurses whose work was related to, or connected with, the operating room. A historical review of early issues of The Canadian Nurse (first published in 1905) reveals a substantial amount of content related to operating room nursing in the twenty year period, beginning in the 1940s, that predated the existence of OR specialty journals. The content was, for the time, both detailed and informative. It was through this journal that operating room nurses, indeed all Canadian nurses, learned about new advances, employment opportunities, educational programs, professional associations, and the achievements of those in the profession. Operating Room Nursing, as an isolated and quickly emerging specialty, was introduced to other nurses via items in The Canadian Nurse journal.

  1. Analysis of the Effect of Disinfection Management in Operating Room on Hospital Infection Control%手术室消毒对感染控制的效果分析

    Institute of Scientific and Technical Information of China (English)

    程锐; 陈伟丽; 叶旭霞

    2016-01-01

    Objective To explore the effect of disinfection management in operating room on hospital infection control.Methods Disinfection and sterilization monitoring data from January 2013 to December 2014 when traditional operating room management was implemented in our hospital was randomly selected as the control group. Disinfection and sterilization monitoring data from January 2015 to December 2015 when disinfection management in operating room was implemented in our hospital was randomly selected as the treatment group. Comparison of the disinfection effect in operating room and incision infection rate between two groups was made.Results The qualified rate of the air, disinfection articles and hand disinfection of medical staffs in operating room after disinfection management was significantly higher than that in control group with statistically significant difference (P<0.05). The infection rate of surgical patients after the implementation of disinfection management in operating room was lower than that in the control group with statistically significant difference (P<0.05).Conclusion Strengthening the disinfection management in operation room can promote the formation of a good habit for medical personnel in operation room and reduce the incision infection rate.%目的探讨手术室消毒管理对医院感染控制的效果。方法随机抽取2013年1月至2014年12月我院实施传统手术室管理模式期间的消毒灭菌监测资料作为对照组,随机抽取2015年1月至2015年12月我院实施手术室消毒管理模式期间的消毒灭菌监测资料作为观察组,对比两组手术室消毒效果及研究期间手术室收治患者切口感染率。结果实施手术室消毒管理后手术室空气、消毒物品及医护人员手消毒合格率均较传统手术室管理提高,差异有统计学意义(P<0.05);实施手术室消毒管理后各科室手术患者手术部位感染率均较传统手术室管理降低,

  2. Influence of advanced room -and building automation and optimized operation control on the energy efficiency of buildings; Einfluss moderner Raum- und Gebaeudeautomation und optimierter Betriebsfuehrung auf die Energieeffizienz von Gebaeuden

    Energy Technology Data Exchange (ETDEWEB)

    Knoll, P.; Peters, B.; Becker, M. [Hochschule Biberach (Germany). Fachgebiet Gebaeudeautomation

    2008-07-01

    There is an increasing awareness of using our energy resources more efficiently which also leads to the finding of the importance of energy-efficient building services and operation. Unfortunately, we often restrict ourselves looking only at the costs of the investment itself instead of taking into account also the costs during the long time of building operation. In particular this is an obvious fact to decisions of investments for room and building automation equipment. However, building automation and control systems (BACS) deliver high potentials for energy savings with regard to the ongoing operation of a building. Thus, in accordance with sustainable building design, it is extremely important to understand buildings in their entirety and to look at their building facilities in an integral way. This article discusses the energy potentials of building automation and control and how the potentials can be calculated and increased. Further more, it will be presented which tools are needed for an optimized building operation management. (orig.)

  3. 整形美容科门诊手术室医院感染隐患与防控对策%Security risks and prevention and control measures of the plastic surgery outpatient operating room of hospital infection

    Institute of Scientific and Technical Information of China (English)

    王靖; 杨爱芝; 赵应兰

    2012-01-01

    目的:探讨整形美容门诊手术室医院感染的安全隐患与控制措施.方法:分析发生感染的危险因素,采取相应的感染预防与控制措施,严格遵守感染预防原则,做好布局、流程、监测等环节的管理.结果:通过预防措施,规范了整形美容患者进入门诊手术室手术的流程,降低了医院感染率,提高了医疗护理质量,避免了医疗纠纷.结论:通过分析整形美容门诊手术室医院感染的安全隐患,加强整形美容门诊手术室医院感染的管理,增加了医院的社会及经济效益.%Objective:To explore the security risks and control measures of cosmetic surgery outpatient operating room and hospital infection. Methods:Ana-lyzed of the occurrence of risk factors for infection, and took the appropriate infection prevention and control measures, strict compliance with infection pre-vention principles,good layout,processes, monitoring and other aspects of management. Results:Through preventive measures,standardized the process of cosmetic surgery patients entered the outpatient operating room surgery, reduced hospital infection rates, improved the quality of medical nursing, avoided medical disputes. Conclusion;Through the analyze the security risks of cosmetic surgery clinic operating room hospital infections,to strengthen the manage-ment of cosmetic surgery to the outpatient operating room of hospital infection,and increase the hospital's social and economic benefits.

  4. Improving pharmacy supply-chain management in the operating room.

    Science.gov (United States)

    Thomas, J A; Martin, V; Frank, S

    2000-12-01

    Anesthesia services can account for a significant portion of a healthcare organization's costs. Deaconess Hospital of Evansville, Indiana, used a collaborative, multidisciplinary effort to implement process improvements that yielded significant cost savings while improving patient care. Shifting responsibility for drug distribution from the operating room (OR) nurses to a pharmacist, the hospital established a satellite pharmacy service for the OR. As a result, the hospital was able to improve control of drug distribution and record-keeping, reduce turnaround time for medication preparation, lower its medication charge error rate, and increase the percentage of surgeries that start on time. The success of the OR satellite pharmacy led the hospital to expand satellite pharmacy services to labor and delivery, the cardiac cath laboratory, and the intensive care units.

  5. Quality of life of nurses in the operating room

    Directory of Open Access Journals (Sweden)

    Raquel Murano Alfaia dos Santos

    2009-03-01

    Full Text Available Objective: To evaluate the quality of life of operating room nurses and collect their opinions as to the influence their professional activity exerts on their quality of life. Methods: This was a cross-sectional study carried out on a sample of 24 nurses that work in the operating room of a large private hospital in the city of São Paulo. Two questionnaires were applied; one was designed by the authors of this research project, and the other was the Quality of Life Questionnaire (WHOQOL-BREF. Rresults: As to quality of life, the environment domain obtained the highest score, while the psychological domain obtained the lowest. When asked if their professional activity in the operating room influenced their quality of life, most responded affirmatively. Regarding the justifications offered by the nurses for the influence of their professional activity on their quality of life, 50% mentioned environment-related stress, responsibilities, duties, risk situations, relationships with the multiprofessional team, and the type of work carried out in the operating room. Cconclusions: The psychological domain obtained the lowest score in the nurse quality of life evaluation, pointing out the need to facilitate and/or encourage nurses to seek psychological support. As to the influence of their professional activity on their quality of life, the nurses mentioned stress related to their work environment and professional activities in the operating room. This highlights the importance of managers in this area, paying greater attention to the individual and collective needs of their employees.

  6. PS Main Control Room (partial view)

    CERN Multimedia

    1974-01-01

    Jean-Pierre Potier (turning buttons) and Bertran Frammery (telephoning) on shift. The 26 GeV Synchrotron and later also its related machines (Linacs 1,2,3; PS-Booster; LEP-Injector Linacs and Electron-Positron Accumulator; Antiproton Accumulator, Antiproton Collector, Low Energy Antiproton Ring and more recently Antiproton Decelerator) were all controlled from the PS control room situated on the Meyrin site. The SPS and LEP were controlled from a separat control centre on the Prevessin site. In 2005 all controls were transferred to the Prevessin centre.

  7. Determination of Anger Expression and Anger Management Styles and an Application on Operating Room Nurses

    Directory of Open Access Journals (Sweden)

    Hülya Aslan

    2016-12-01

    Full Text Available This research has been carried out in order to determine anger expression and anger management styles in operating room nurses. By applying an in-depth interview technique on operating room nurses working in a private hospital, a qualitative study has been performed in order to determine anger expression and anger management styles in operating room nurses. The interview consisted of ten questions such as demographic questions addressing the workers’ age, sex, education level and duration of employment in the organization they work, aiming to determine their anger expression and anger management styles. Since operating room environments contain various risk factors, and require active team work in a stressful dynamic setting under excessive workload, , it has been found that operating room nurses display their anger through loud speaking, fail to settle their anger positively, fail to control their anger in a behavioural pattern despite their cognitive awareness in anger management. Thus, it has been suggested that operating room nurses should be trained on anger management methods so that they can manage their anger in a stressful operating room environment.

  8. Cooperative research for human factors review of advanced control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Park, Jae Chang; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul

    2000-12-01

    This project has been performed as cooperative research between KAERI and USNRC. Human factors issues related to soft controls, which is one of key features of advanced HSI, are identified in this project. The issues are analyzed for the evaluation approaches in either experimental or analytical ways. Also, issues requiring additional researches for the evaluation of advanced HSI are identified in the areas of advanced information systems design, computer-based procedure systems, soft controls, human systems interface and plant modernization process, and maintainability of digital systems. The issues are analyzed to discriminate the urgency of researches on it to high, medium, and low levels in consideration of advanced HSI development status in Korea, and some of the issues that can be handled by experimental researches are identified. Additionally, an experimental study is performed to compare operator's performance on human error detection in advanced control rooms vs. in conventional control rooms. It is found that advanced control rooms have several design characteristics hindering operator's error detection performance compared to conventional control rooms.

  9. Google Glass in the Operating Room: The Plastic Surgeon's Perspective.

    Science.gov (United States)

    Sinkin, Jeremy C; Rahman, Omar F; Nahabedian, Maurice Y

    2016-07-01

    New technologies and innovations are common in the delivery of modern health care. Google Glass is one such device gaining increased attention in medical specialties. The authors surveyed residents and attending physicians in the Department of Plastic Surgery, MedStar Georgetown University Hospital, on their experience using Google Glass in the operating room. Ease of use, quality of images, gaze disruption, and distraction during surgery were measured. Overall, subjects found the device to be comfortable and satisfying to wear and use during surgery to capture images of good quality. Despite some identified weaknesses, Google Glass is a unique technology with a promising plastic surgical application in the operating room.

  10. Association Between Surgeon Scorecard Use and Operating Room Costs.

    Science.gov (United States)

    Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

    2017-03-01

    Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases

  11. Modification and updating of documentation in equipment of panels of control room in nuclear power plant operation; Modificacion y actualizacion de documentacion en aparatos de paneles de sala de control en una central nuclear en operacion

    Energy Technology Data Exchange (ETDEWEB)

    Agudo Montero, L.

    2013-07-01

    The present paper describes a case very unique specific design of interactive 2D-CAD application, that has been developed by Empresarios Agrupados as engineering support to the nuclear power plants, aware of the problem that exists with the documentation of the instruments and devices that are on the panels of Control room, and that only have the documentation generated in its day by the manufacturers of these panels. To this end, an application (application DOPAB) has been developed to help solve the problem of management, design and modification of wiring and wiring devices existing in the Control room control panels.

  12. 8S管理在手术室医院感染控制中的应用%The application of 8S management in the control of operating room hospital infection

    Institute of Scientific and Technical Information of China (English)

    姚锦尚; 肖平平; 张梅

    2015-01-01

    目的::探讨通过实施8S精益管理提高手术室医院感染控制水平的有效管理方法。方法:选择2012年1月~2013年12月我院手术室环境卫生学及消毒灭菌监测资料,将2012年1~12月医院感染控制主要实施规范化管理措施分为对照组;2013年1~12月在规范化管理的基础上引入8S管理理念(即整理、整顿、清扫、清洁、素养、安全、学习、节约)分为观察组。查阅同期产科、普外科、骨科手术出院病人病历,分析比较两组手术室环境卫生学和消毒灭菌监测资料数据,以及不同科室手术患者的手术部位感染数据。结果:两组手术室环境卫生学及消毒灭菌合格率比较手术间空气与医务人员手监测数据差异有统计学意义(P<0.05);不同科室手术患者的手术部位感染数据有统计学意义(P<0.05)。结论:手术室实施8S精益管理,可以促进医务人员形成良好的行为习惯,提高专业文化素养,提高手卫生依从性,有效降低手术患者手术部位感染率。%Objective:To investigate the effctive method of improving the control level of operating room hospital infection through the application of 8S man-agement. Methods:In 2012,standardized management measures were mainy applied in the control of operating room management,whose monioring data were classified as the control group. In the year of 2013,on the base of standardized management,8S management ( sort,straighten,sweep,sanitary,sentiment, safety,study and save) were introduced,whose data were classified as the observation group. Applying method of retrospective survey,by inspecting the re-cords of obstetric,general surgery and orthopedic patients who had been discharged in 2012 and 2013,analyzed and compared the data of sterilization and environmental hygiene and the data of surgical site infection of patients of various departments. Results:Comparing the passing rate of sterilization and envi

  13. An Electronic Logbook for the HEP Control Room

    Institute of Scientific and Technical Information of China (English)

    G.Roediger; P.Pomatto; 等

    2001-01-01

    The Control Room Logbook(CRL)is designed to improve and replace the paper logbooks traditionally used in the HEP accelerator control room.Its features benefit the on-line coordinator,the shift operators,and the remote observers,This paper explains some of the most attractive features for each of these roles.The features include the ability to configure the logbook for the specific needs of a collaboration,a large variety of entry types operator can add by simply clicking and dragging,and a flexible web interface for the remote observer to keep up with control room activities.The entries are saved as UTF-8 based XML files,which allowed us to give the data structure and meaning such that it can easily be parsed in the present and far into the future.The XML tag data is also indexed in a relational database,making queries on dates,keyworks,entry type and other criteria feasible and fast .The CRL is used in the D0 control room.This presentation also discusses our experience with deployment,platform independence and other interesting issues that arose with the installation and use of logbook.

  14. Control room envelope unfiltered air inleakage test protocols

    Energy Technology Data Exchange (ETDEWEB)

    Lagus, P.L. [Lagus Applied Technology, San Diego, CA (United States); Grot, R.A. [Lagus Applied Technology, Olney, MD (United States)

    1997-08-01

    In 1983, the Advisory Committee on Reactor Safeguards (ACRS) recommended that the US NRC develop a control room HVAC performance testing protocol. To date no such protocol has been forthcoming. Beginning in mid-1994, an effort was funded by NRC under a Small Business Innovation Research (SBIR) grant to develop several simplified test protocols based on the principles of tracer gas testing in order to measure the total unfiltered inleakage entering a CRE during emergency mode operation of the control room ventilation system. These would allow accurate assessment of unfiltered air inleakage as required in SRP 6.4. The continuing lack of a standard protocol is unfortunate since one of the significant parameters required to calculate operator dose is the amount of unfiltered air inleakage into the control room. Often it is assumed that, if the Control Room Envelope (CRE) is maintained at +1/8 in. w.g. differential pressure relative to the surroundings, no significant unfiltered inleakage can occur it is further assumed that inleakage due to door openings is the only source of unfiltered air. 23 refs., 13 figs., 2 tabs.

  15. Silence, power and communication in the operating room

    Science.gov (United States)

    Gardezi, Fauzia; Lingard, Lorelei; Espin, Sherry; Whyte, Sarah; Orser, Beverley; Baker, G Ross

    2009-01-01

    Title. Silence, power and communication in the operating room Aim This paper is a report of a study conducted to explore whether a 1- to 3-minute preoperative interprofessional team briefing with a structured checklist was an effective way to support communication in the operating room. Background Previous research suggests that nurses often feel constrained in their ability to communicate with physicians. Previous research on silence and power suggests that silence is not only a reflection of powerlessness or passivity, and that silence and speech are not opposites, but closely interrelated. Methods We conducted a retrospective study of silences observed in communication between nurses and surgeons in a multi-site observational study of interprofessional communication in the operating room. Over 700 surgical procedures were observed from 2005–2007. Instances of communication characterized by unresolved or unarticulated issues were identified in field notes and analysed from a critical ethnography perspective. Findings We identified three forms of recurring ‘silences’: absence of communication; not responding to queries or requests; and speaking quietly. These silences may be defensive or strategic, and they may be influenced by larger institutional and structural power dynamics as well as by the immediate situational context. Conclusions There is no single answer to the question of why ‘nobody said anything’. Exploring silences in relation to power suggests that there are multiple and complex ways that constrained communication is produced in the operating room, which are essential to understand in order to improve interprofessional communication and collaboration.

  16. Improving the Interdisciplinary Team Work in the Operating Room

    DEFF Research Database (Denmark)

    Tørring, Birgitte

    2016-01-01

    the black box of teamwork in search for relational elements critical to successful collaboration and communication. Few single studies exists which explore how RC could be observed and improved in this context. The present study examines surgical teams in selected operating rooms (OR) focusing on RC...

  17. Delays in the operating room: signs of an imperfect system.

    Science.gov (United States)

    Wong, Janice; Khu, Kathleen Joy; Kaderali, Zul; Bernstein, Mark

    2010-06-01

    Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays. One neurosurgeon prospectively recorded all errors, including perioperative delays, for consecutive patients undergoing elective procedures from May 2000 to February 2009. We analyzed the prevalence, causes and impact of perioperative system delays that occurred in one neurosurgeon's practice. A total of 1531 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common cause of delay was equipment failure. The first cases of the day and cranial cases had more delays than subsequent cases and spinal cases, respectively. A delay in starting the first case was associated with subsequent delays. Delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines.

  18. Facets of operational performance in an emergency room (ER)

    NARCIS (Netherlands)

    van der Vaart, Taco; Vastag, Gyula; Wijngaard, Jacob

    2011-01-01

    This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's opera

  19. Decision support system for the operating room rescheduling problem

    NARCIS (Netherlands)

    Essen, van J. Theresia; Hurink, J.L.; Hartholt, Woutske; Akker, van den Bernd J.

    2012-01-01

    Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other in

  20. Gynaecological surgical training in the operating room : an exploratory study

    NARCIS (Netherlands)

    van der Houwen, Clasien; Boor, Klarke; Essed, Gerard G. M.; Boendermaker, Peter M.; Scherpbier, Albert A. J. J. A.; Scheele, Fedde

    2011-01-01

    Objective: One of the challenging goals of gynaecological education is preparing trainees for independent practice of surgery. Research, however, on how to acquire surgical skills in the operating room safely, effectively and efficiently is scarce. We performed this study to explore trainers' and tr

  1. 层流手术室感染控制存在的问题及护理措施%Laminar flow operating room nursing infection control problems and the presence of

    Institute of Scientific and Technical Information of China (English)

    敖永琼

    2014-01-01

    Objective: To study the problems existing in the laminar flow operating room infection control and nursing measures. Methods: to choose between September 2013 and December 2013 in our hospital operating room for surgery of 190 cases as control group. Since the implementation of infection control management of between December 2013 and February 2013 in our hospital operating room as observation group, 260 patients underwent surgery. Combined with the specific situation of the hospital itself, the laminar flow operating room infection control the infection incidence of patients before and after comparison with data of satisfaction. Results: the control group of 190 cases occurred in 6 cases of infection, infection occurs in the observation group of 260 patients with 2 cases, significantly lower than the control group; Control group satisfaction was 66.84%, the observation group of satisfaction was 94.23%, obviously better than the control group. Conclusion: the laminar flow operating room infection control comprehensive nursing measures, to improve patient satisfaction and reduce the incidence of infection in patients with plays a very important significance, is worth popularizing widely.%目的::探讨层流手术室感染控制存在的问题及护理措施。方法:选取2013年9月至2013年12月在我院手术室进行手术的190例患者作为对照组。自实施感染控制管理之后的2013年12月至2014年2月在我院手术室进行手术的260例患者作为观察组。结合医院本身具体情况,将层流手术室感染控制前后患者的感染发生率与满意度数据进行比较。结果:对照组190例患者中发生感染的有6例,观察组260例患者中发生感染的有2例,明显低于对照组;对照组满意度为66.84%,观察组满意度为94.23%,明显优于对照组。结论:对层流手术室的感染控制采取全面的护理措施,对于提高患者满意度和降低患者的感染发生率起着非常

  2. Preoperative planning and designing of a fluorocompatible endourology operating room.

    Science.gov (United States)

    Sabnis, Ravindra B; Mishra, Shashikant; Sharma, Rajan; Desai, Mahesh R

    2009-10-01

    A dedicated fluoroscopic-compatible operating room (OR) for endourologic procedures, such as percutaneous nephrolithotomy and ureteroscopy, is structurally and functionally different from the general OR. Publications with practical details are scarce, imposing a challenge in construction of such an OR. We outline a practical approach for the design and construction of a modern flourocompatible endourology OR. There were no publications related to a dedicated endourology OR in Medline. A search was then performed for English language articles on OR designing, fluoroscopy in the OR, data archiving, and data relay. We also surveyed the existing endourology OR in different hospitals and analyzed the available technology for audiovisual capture and relay in surgery. This article was then prepared, covering the relevant areas on designing a dedicated flourocompatible endourology OR. Close cooperation and interaction between an architect and expert construction manager for designing, development, and construction of an OR are necessary. Strategic equipment placement with booms is essential to increase the efficiency and safety within the surgical space. Distinct features of an endourology OR are thickness of the walls for radiation protection, wide OR gate, central floor water exit drain, flourocompatible rotatable OR table, C-arm unit, minimum three hanging thin-film transistor (TFT) screen monitors, and endoscopic equipment supported on a boom. The anesthetic boom should be retractable and movable from one end of the OR table to other. The OR should have an electronic workstation strategically located at one corner for data capture, archiving, and telementoring. Data relay of the OR procedure is facilitated by a control room located in the vicinity of the OR. Designing the layout of the OR is extremely important, necessitating thoughtful planning to provide hassle-free movement, comfort to the surgeon, and efficient data archiving and transmission during a surgical

  3. 层流手术室空气中浮游菌超标原因与控制%The causes and control of excessive planktonic bacteria in the air of laminar flow operation room

    Institute of Scientific and Technical Information of China (English)

    雷凤琼; 唐葶婷; 卞红强; 罗万军; 徐润林; 范丽; 杨泳茹

    2015-01-01

    目的:研究层流手术室空气中浮游菌超标的原因与控制,以降低感染发生率。方法对2012年7月-2014年7月层流手术室连续100台手术进行检测,使用浮游菌采样器和尘埃粒子计数仪在手术室中不同的时间段进行多点采样,包括手术区和非手术区(周边区),对所测浮游菌及尘埃粒子进行计数统计,分析浮游菌、尘埃粒子超标的原因,提出处理对策。结果层流手术室在手术前浮游菌、尘埃粒子数量均符合标准,手术开始后浮游菌及尘埃粒子开始呈上升趋势,直到手术结束时达到最大值,在手术结束后浮游菌及尘埃粒子开始下降,30 min后恢复标准,差异有统计学意义(P<0.05)。结论在手术室中,尘埃粒子及浮游菌超标的原因是由于手术的动态运行、人员的走动、操作等均导致其上升,而严格的消毒、防止感染是保证手术室洁净的关键。%OBJECTIVE To study the causes and control of excessive planktonic bacteria in the air of laminar flow operation room so as to reduce infection rates .METHODS A total of 100 consecutive operation of laminar flow op‐eration from Jul .2012 to Jul .2014 were detected .Multi‐point sampling in different time period in operation rooms was conducted by planktonic bacteria sampler and dust particle calculating instrument in different areas ,including the operation area and non operation area (peripheral regions) .The planktonic bacteria and dust particle were counted and the causes for excessive planktonic bacteria and dust particle were analyzed to come up with some measures .RESULTS Before surgeries ,numbers of planktonic bacteria and dust particles in laminar flow operation room met the standards .But w hen the operation began ,numbers of planktonic bacteria and dust particle increased rapidly and reached the maximum at the end of the surgery .After that ,the numbers started to reduce and 30 mi‐nutes later

  4. The Prevessin Control Room during LEP's start up in 1989.

    CERN Multimedia

    1989-01-01

    The Prévessin Control Room saw its first momentous event when the 400 GeV beam for the SPS was commissioned in the presence of Project Leader John Adams. It was also here that the first proton-antiproton collisions were observed, in 1981. Eight years later, in 1989, operators and directors alike jumped for joy at the announcement of the first electron-positron collisions at the start up of LEP, the biggest accelerator in the world.

  5. Cost-benefit analysis of different air change rates in an operating room environment.

    Science.gov (United States)

    Gormley, Thomas; Markel, Troy A; Jones, Howard; Greeley, Damon; Ostojic, John; Clarke, James H; Abkowitz, Mark; Wagner, Jennifer

    2017-09-08

    Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry. Simply increasing air change rates in the operating rooms tested did not necessarily provide an overall cleaner environment, but did substantially increase energy consumption and costs. Additionally, and unexpectedly, significant differences in microbial load and air velocity were detected between the sterile fields and back instrument tables. Increasing the ventilation rates in operating rooms in an effort to improve clinical outcomes and potentially reduce surgical site infections does not necessarily provide cleaner air, but does typically increase operating costs. Efficient distribution or management of the air can improve quality indicators and potentially reduce the number of air changes required. Measurable environmental quality indicators could be used in lieu of or in addition to air change rate requirements to optimize cost and quality for an operating room and other critical environments. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study.

    NARCIS (Netherlands)

    Moual, N. le; Varraso, R.; Zock, J.P.; Henneberger, P.; Speizer, F.E.; Kauffmann, F.; Camargo, C.A.

    2013-01-01

    Objective: To assess the associations between operating room (OR) nursing, a category of health care workers at high risk of exposure to various inhaled agents, and asthma severity/control among women with asthma. Methods: The level of severity/control in nurses with prevalent doctor-diagnosed asthm

  7. Sedation of infants and children outside of the operating room.

    Science.gov (United States)

    Tobias, Joseph D

    2015-08-01

    Although adults may be able to tolerate procedures without sedation, developmental and cognitive issues often mandate the use of sedation in infants and children. There has been a shift in the philosophy regarding sedation with an increasing recognition of the negative psychological and physiological aspects of inadequate sedation. The expansion of our technology continues to result in an increasing number of techniques, which require sedation outside of the operating room environment. These factors have contributed to an ever growing number of pediatric patients presenting themselves for procedural sedation. This chapter will discuss issues regarding the provision of anesthesia outside of the operating room for pediatric patients including current guidelines for patient assessment prior to procedural, monitoring during sedation, and a discussion of some of the more commonly utilized sedative and analgesic agents within the pediatric population.

  8. A Web-Based Operating Room Management Educational Tool.

    Science.gov (United States)

    Tsai, Mitchell H; Haddad, Daniel J; Friend, Alexander F; Bender, S Patrick; Davidson, Melissa L

    2016-08-01

    In 2010, our department instituted a nonclinical, administrative rotation in operating room management for anesthesiology residents. Subsequently, we mandated the rotation for all senior anesthesiology residents in 2013. In 2014, under the auspices of the American Society of Anesthesiologists, we developed a web-based module covering the basics of finance, accounting, and operating room management. A multiple-choice test was given to residents at the beginning and end of the rotation, and we compared the mean scores between residents who took the traditional course and residents who took the web-based module. We found no significant difference between the groups of residents, suggesting that the web-based module is as effective as traditional didactics.

  9. The utilization of magnetic resonance imaging in the operating room.

    Science.gov (United States)

    Ménard, C; Pambrun, J-F; Kadoury, S

    Online image guidance in the operating room using ultrasound imaging led to the resurgence of prostate brachytherapy in the 1980s. Here we describe the evolution of integrating MRI technology in the brachytherapy suite or operating room. Given the complexity, cost, and inherent safety issues associated with MRI system integration, first steps focused on the computational integration of images rather than systems. This approach has broad appeal given minimal infrastructure costs and efficiencies comparable with standard care workflows. However, many concerns remain regarding accuracy of registration through the course of a brachytherapy procedure. In selected academic institutions, MRI systems have been integrated in or near the brachytherapy suite in varied configurations to improve the precision and quality of treatments. Navigation toolsets specifically adapted to prostate brachytherapy are in development and are reviewed. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  10. Advanced Technologies in Safe and Efficient Operating Rooms

    Science.gov (United States)

    2006-02-01

    area of Informatics, a Meta analysis of commercially available positioning technolgies has been completed. A sampling of these technologies was...intense care provided for many patients. The operating room forms the nucleus of mobile military hospitals. Whether found in civilian or military...encompasses systems consisting of mobile transmitters and fixed or semi-fixed receivers used wirelessly and without human intervention to identify the

  11. Human factors design review guidelines for advanced nuclear control room technologies

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J.; Brown, W. (Brookhaven National Lab., Upton, NY (United States)); Granda, T.; Baker, C. (Carlow Associates, Inc., Fairfax, VA (United States))

    1991-01-01

    Advanced control rooms (ACRs) for future nuclear power plants are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale, general approach, and initial development of an NRC Advanced Control Room Design Review Guideline. 20 refs., 1 fig.

  12. Development of an operating room pharmacy substation on a restricted budget.

    Science.gov (United States)

    Buchanan, E C; Gaither, M W

    1986-07-01

    Pharmaceutical services implemented in an operating room (OR) pharmacy substation without addition of staff in a 764-bed teaching hospital with 22 operating rooms are described. In 1984 an interdepartmental task force recommended that pharmacy take control of responsibility for controlled drugs used in anesthesia. The anesthesia department contributed space for a pharmacy substation and some of the necessary equipment. Two technicians staff the substation (1.5 full-time equivalent positions); pharmacy contributed 0.5 FTE and the additional FTE was obtained through staffing adjustments in other departments. Anesthesiologists and nurse anesthetists obtain controlled drugs directly from the technicians, and records of drug disposition are compared with inventory twice daily. The substation also handles exchange carts for noncontrolled drugs for anesthesia and for other drugs used in the operating rooms. Total cost (additional cost to pharmacy and other departments) for operating the substation for its first year was +2161, and there were no unresolved discrepancies in controlled drug accounting. Undocumented use of noncontrolled drugs has been reduced by 67%, and cooperation and communication between the pharmacy and anesthesia departments has improved. Substation personnel do not prepare intravenous admixtures or provide clinical services. An operating room substation staffed by technicians 10.5 hours daily Monday through Friday provided cost-effective pharmacy control of drugs used in the OR.

  13. Complementing Operating Room Teaching With Video-Based Coaching.

    Science.gov (United States)

    Hu, Yue-Yung; Mazer, Laura M; Yule, Steven J; Arriaga, Alexander F; Greenberg, Caprice C; Lipsitz, Stuart R; Gawande, Atul A; Smink, Douglas S

    2017-04-01

    Surgical expertise demands technical and nontechnical skills. Traditionally, surgical trainees acquired these skills in the operating room; however, operative time for residents has decreased with duty hour restrictions. As in other professions, video analysis may help maximize the learning experience. To develop and evaluate a postoperative video-based coaching intervention for residents. In this mixed methods analysis, 10 senior (postgraduate year 4 and 5) residents were videorecorded operating with an attending surgeon at an academic tertiary care hospital. Each video formed the basis of a 1-hour one-on-one coaching session conducted by the operative attending; although a coaching framework was provided, participants determined the specific content collaboratively. Teaching points were identified in the operating room and the video-based coaching sessions; iterative inductive coding, followed by thematic analysis, was performed. Teaching points made in the operating room were compared with those in the video-based coaching sessions with respect to initiator, content, and teaching technique, adjusting for time. Among 10 cases, surgeons made more teaching points per unit time (63.0 vs 102.7 per hour) while coaching. Teaching in the video-based coaching sessions was more resident centered; attendings were more inquisitive about residents' learning needs (3.30 vs 0.28, P = .04), and residents took more initiative to direct their education (27% [198 of 729 teaching points] vs 17% [331 of 1977 teaching points], P Video-based coaching is a novel and feasible modality for supplementing intraoperative learning. Objective evaluation demonstrates that video-based coaching may be particularly useful for teaching higher-level concepts, such as decision making, and for individualizing instruction and feedback to each resident.

  14. Start time delays in operating room: Different perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2011-01-01

    Full Text Available Background: Healthcare expenditure is a serious concern, with escalating costs failing to meet the expectations of quality care. The treatment capacities are limited in a hospital setting and the operating rooms (ORs. Their optimal utilization is vital in efficient hospital management. Starting late means considerable wait time for staff, patients and waste of resources. We planned an audit to assess different perspectives of the residents in surgical specialities and anesthesia and OR staff nurses so as to know the causative factors of operative delay. This can help develop a practical model to decrease start time delays in operating room (ORs. Aims: An audit to assess different perspectives of the Operating room (OR staff with respect to the varied causative factors of operative delay in the OR. To aid in the development of a practical model to decrease start time delays in ORs and facilitate on-time starts at Jai Prakash Narayan Apex Trauma centre (JPNATC, All India Institute of Medical Sciences (AIIMS, New Delhi. Methods: We prepared a questionnaire seeking the five main reasons of delay as per their perspective. Results: The available data was analysed. Analysis of the data demonstrated the common causative factors in start time operative delays as: a lack of proper planning, deficiencies in team work, communication gap and limited availability of trained supporting staff. Conclusions: The preparation of the equipment and required material for the OR cases must be done well in advance. Utilization of newer technology enables timely booking and scheduling of cases. Improved inter-departmental coordination and compliance with preanesthetic instructions needs to be ensured. It is essential that the anesthesiologists perform their work promptly, well in time . and supervise the proceedings as the OR manager. This audit is a step forward in defining the need of effective OR planning for continuous quality improvement.

  15. Requirements for Control Room Computer-Based Procedures for use in Hybrid Control Rooms

    Energy Technology Data Exchange (ETDEWEB)

    Le Blanc, Katya Lee [Idaho National Lab. (INL), Idaho Falls, ID (United States); Oxstrand, Johanna Helene [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey Clark [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-05-01

    Many plants in the U.S. are currently undergoing control room modernization. The main drivers for modernization are the aging and obsolescence of existing equipment, which typically results in a like-for-like replacement of analogue equipment with digital systems. However, the modernization efforts present an opportunity to employ advanced technology that would not only extend the life, but enhance the efficiency and cost competitiveness of nuclear power. Computer-based procedures (CBPs) are one example of near-term advanced technology that may provide enhanced efficiencies above and beyond like for like replacements of analog systems. Researchers in the LWRS program are investigating the benefits of advanced technologies such as CBPs, with the goal of assisting utilities in decision making during modernization projects. This report will describe the existing research on CBPs, discuss the unique issues related to using CBPs in hybrid control rooms (i.e., partially modernized analog control rooms), and define the requirements of CBPs for hybrid control rooms.

  16. Application of quality control circle activity in reducing the operating room nurses tour times out%品管圈活动在减少手术室巡回护士外出次数中的应用

    Institute of Scientific and Technical Information of China (English)

    程慧

    2016-01-01

    目的:运用品管圈(QCC)活动减少手术室巡回护士外出次数。方法:组建品管圈活动小组,通过圈员投票将减少巡回护士外出作为本次活动的主题,按照品管圈活动步骤及方法,对影响手术间巡回护士外出次数的原因进行分析,制定相应的措施并组织实施。结果:手术间巡回护士外出次数由品管圈活动前的8.29次/台降低到5.61次/台,降幅达32.32%。结论:通过品管圈活动能提高护士工作效率,保证患者手术安全,推进手术室护理管理标准化。%Objective:To apply quality control circle (QCC) tour activities to reduce go out of the operating room nurses.Method:Reduced the visiting nurse go out as the theme of the event by circle member vote to form QCC activity group,according to the QCC activity method,analyzed the reasons of the affecting operation between circuit nurses,and the number of out formulate corresponding measures and organize their implementation.Results:Between operation circuit nurses out by QCC activity times 8.29 times down to 5.61 times,drop of 32.32%.Conclusion:Through the QCC activity increase work efficiency of nurses,to ensure the safety of patients,and promote standardization of the operating room nursing management.

  17. Advanced control room evaluation: General approach and rationale

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J.M. (Brookhaven National Lab., Upton, NY (USA)); Wachtel, J. (Nuclear Regulatory Commission, Washington, DC (USA))

    1991-01-01

    Advanced control rooms (ACRs) for future nuclear power plants (NPPs) are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale and general approach to the development of a human factors review guideline for ACRs. The factors influencing the guideline development are discussed, including the review environment, the types of advanced technologies being addressed, the human factors issues associated with advanced technology, and the current state-of-the-art of human factors guidelines for advanced human-system interfaces (HSIs). The proposed approach to ACR review would track the design and implementation process through the application of review guidelines reflecting four review modules: planning, design process analysis, human factors engineering review, and dynamic performance evaluation. 21 refs.

  18. Patient safety in the operating room: an intervention study on latent risk factors

    Directory of Open Access Journals (Sweden)

    van Beuzekom Martie

    2012-06-01

    Full Text Available Abstract Background Patient safety is one of the greatest challenges in healthcare. In the operating room errors are frequent and often consequential. This article describes an approach to a successful implementation of a patient safety program in the operating room, focussing on latent risk factors that influence patient safety. We performed an intervention to improve these latent risk factors (LRFs and increase awareness of patient safety issues amongst OR staff. Methods Latent risk factors were studied using a validated questionnaire applied to the OR staff before and after an intervention. A pre-test/post-test control group design with repeated measures was used to evaluate the effects of the interventions. The staff from one operating room of an university hospital acted as the intervention group. Controls consisted of the staff of the operating room in another university hospital. The outcomes were the changes in LRF scores, perceived incident rate, and changes in incident reports between pre- and post-intervention. Results Based on pre-test scores and participants’ key concerns about organizational factors affecting patient safety in their department the intervention focused on the following LRFs: Material Resources, Training and Staffing Recourses. After the intervention, the intervention operating room - compared to the control operating room - reported significantly fewer problems on Material Resources and Staffing Resources and a significantly lower score on perceived incident rate. The contribution of technical factors to incident causation decreased significantly in the intervention group after the intervention. Conclusion The change of state of latent risk factors can be measured using a patient safety questionnaire aimed at these factors. The change of the relevant risk factors (Material and Staffing resources concurred with a decrease in perceived and reported incident rates in the relevant categories. We conclude that

  19. Closed-loop approach for situation awareness of medical devices and operating room infrastructure

    Directory of Open Access Journals (Sweden)

    Rockstroh Max

    2015-09-01

    Full Text Available In recent years, approaches for information and control integration in the digital operating room have emerged. A major step towards an intelligent operating room and a cooperative technical environment would be autonomous adaptation of medical devices and systems to the surgical workflow. The OR staff should be freed from information seeking and maintenance tasks. We propose a closed-loop concept integrating workflow monitoring, processing and (semi-automatic interaction to bridge the gap between OR integration of medical devices and workflow-related information management.

  20. Feasibility Assessment of Performing Surgery in a Deployable Medical System Operating Room

    Science.gov (United States)

    2002-05-01

    Nosocomial infections are easily prevented if the hospital and its staff follow well-recognized sanitation and hygiene protocols. The Guidelines for...instance, frequent hand washing has been shown to significantly lessen the incidence of nosocomial infections . In addition, improved operating room...risk management. 26 Criteria included the following: noise exposure, nosocomial infections , environmental controls, air exchanges, and electrical

  1. Safety culture in the gynecology robotics operating room.

    Science.gov (United States)

    Zullo, Melissa D; McCarroll, Michele L; Mendise, Thomas M; Ferris, Edward F; Roulette, G D; Zolton, Jessica; Andrews, Stephen J; von Gruenigen, Vivian E

    2014-01-01

    To measure the safety culture in the robotics surgery operating room before and after implementation of the Robotic Operating Room Computerized Checklist (RORCC). Prospective study. Gynecology surgical staff (n = 32). An urban community hospital. The Safety Attitudes Questionnaire domains examined were teamwork, safety, job satisfaction, stress recognition, perceptions of management, and working conditions. Questions and domains were described using percent agreement and the Cronbach alpha. Paired t-tests were used to describe differences before and after implementation of the checklist. Mean (SD) staff age was 46.7 (9.5) years, and most were women (78%) and worked full-time (97%). Twenty respondents (83% of nurses, 80% of surgeons, 66% of surgical technicians, and 33% of certified registered nurse anesthetists) completed the Safety Attitudes Questionnaire; 6 were excluded because of non-matching identifiers. Before RORCC implementation, the highest quality of communication and collaboration was reported by surgeons and surgical technicians (100%). Certified registered nurse anesthetists reported only adequate levels of communication and collaboration with other positions. Most staff reported positive responses for teamwork (48%; α = 0.81), safety (47%; α = 0.75), working conditions (37%; α = 0.55), stress recognition (26%; α = 0.71), and perceptions of management (32%; α = 0.52). No differences were observed after RORCC implementation. Quality of communication and collaboration in the gynecology robotics operating room is high between most positions; however, safety attitude responses are low overall. No differences after RORCC implementation and low response rates may highlight lack of staff support. Copyright © 2014. Published by Elsevier Inc.

  2. Fire in the Operating Room During Hypospadias Repair.

    Science.gov (United States)

    Boscarelli, Alessandro; Frediani, Simone; Ceccanti, Silvia; Cervellone, Alice; Pesce, Maria Vittoria; Cozzi, Denis A

    2017-11-01

    Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery.

  3. Application effect of predictive nursing care in the control of operating room infection%预见性护理在手术室感染控制中的应用效果

    Institute of Scientific and Technical Information of China (English)

    万惠贞; 梁小敏

    2015-01-01

    Objective To explore the application effect of predictive nursing care in operating room infection control. Methods 96 cases of patients who required surgical treatment in our hospital from April to October 2014 were selected, and they were randomly assigned to experiment group and control group according to admission order,with 48 cases in each group.The control group was given regular regular nursing care,experiment group was given predictive nursing care.The incidence of infection,nursing satisfaction,settlement bacteria content of object surface and microbial content of air in operating room in two groups was compared. Results The incidence of infection in experiment group was 4.17%,which was significantly less than 14.58% of control group(P<0.05).Nursing total satisfaction in experiment group was 97.72%,which was higher than 85.42% of control group (P<0.05).Surface sampling results and air sampling results of experiment group before and after surgery were better than those of control group (P<0.05). Conclusion Predictive nursing care carried out in the control of operating room infection can effectively improve surface disinfection and air disinfection effect before and after operation,reduce the incidence of surgical infection,and improve patient satisfaction of nursing work,it is of important clinical significance,which is worthy of popularization and application.%目的:探讨预见性护理在手术室感染控制中的应用效果。方法选取2014年4~10月我院手术室收治的96例需行手术治疗的患者,按照入院顺序将其随机分为实验组与对照组,各48例。对照组患者采用常规护理方法,实验组患者采用预见性护理。比较两组患者的感染发生率、护理满意度以及手术室物体表面的沉降菌含量与空气中含菌量。结果实验组的感染发生率为4.17%,显著低于对照组的14.58%(P<0.05);实验组的护理总满意度为97.72%,高于对照组的85.42%(P<0.05);实验

  4. Control and management of nosocomial infection in plastic and reconstructive surgery operating room%整形修复科手术室医院感染的控制与管理

    Institute of Scientific and Technical Information of China (English)

    王艳; 张金凤; 孙建荷; 边亚欣

    2012-01-01

    目的 探讨整形修复科手术室医院感染的预防与管理方法,防止医院感染,确保医疗护理安全及质量.方法 针对整形修复科手术室的工作特点,加强医院感染控制管理,落实医院感染管理的规章制度和工作规范,严格执行有关技术操作规范和工作标准,有效预防和控制医院感染,防止医院感染对患者造成的危害,确保患者和工作人员的身体健康,创造合格的手术环境.结果 2009年3月-2011年6月共进行整形修复手术3026例,从未因手术室各环节因素造成的医院感染.结论 严格贯彻落实医院感染控制管理制度,可有效防止医院感染的发生,是整形手术医疗安全和质量的重要保障.%OBJECTIVE To explore the prevention and management methods of nosocomial infections in plastic and reconstructive surgery operating room, so as to prevent nosocomial infections and ensure the medical care quality and safety. METHODS In accordance with the working characteristics of plastic and reconstructive surgery operating room, the control and management of nosocomial infections were strengthened. The control rules and working standards were implemented, and the relevant technical standards and strict operating procedures for sterilization were executed to protect patients and staff from nosocomial infections and to create qualified surgical environment. RESULTS No nosocomial infection was reported among 3026 cases of plastic and reconstructive surgery from Mar 2009 to Jun 2011. CONCLUSION As the control rules and working standards of nosocomial infection are strictly implemented, the hospital infection can be effectively prevented, which can favor the quality and safety of the plastic operation.

  5. Remote control of magnetostriction-based nanocontacts at room temperature.

    Science.gov (United States)

    Jammalamadaka, S Narayana; Kuntz, Sebastian; Berg, Oliver; Kittler, Wolfram; Kannan, U Mohanan; Chelvane, J Arout; Sürgers, Christoph

    2015-09-01

    The remote control of the electrical conductance through nanosized junctions at room temperature will play an important role in future nano-electromechanical systems and electronic devices. This can be achieved by exploiting the magnetostriction effects of ferromagnetic materials. Here we report on the electrical conductance of magnetic nanocontacts obtained from wires of the giant magnetostrictive compound Tb0.3Dy0.7Fe1.95 as an active element in a mechanically controlled break-junction device. The nanocontacts are reproducibly switched at room temperature between "open" (zero conductance) and "closed" (nonzero conductance) states by variation of a magnetic field applied perpendicularly to the long wire axis. Conductance measurements in a magnetic field oriented parallel to the long wire axis exhibit a different behaviour where the conductance switches between both states only in a limited field range close to the coercive field. Investigating the conductance in the regime of electron tunneling by mechanical or magnetostrictive control of the electrode separation enables an estimation of the magnetostriction. The present results pave the way to utilize the material in devices based on nano-electromechanical systems operating at room temperature.

  6. Alertness, performance and off-duty sleep on 8-hour and 12-hour night shifts in a simulated continuous operations control room setting

    Energy Technology Data Exchange (ETDEWEB)

    Baker, T.L. [Institute for Circadian Physiology, Boston, MA (United States)

    1995-04-01

    A growing number of nuclear power plants in the United States have adopted routine 12-hr shift schedules. Because of the potential impact that extended work shifts could have on safe and efficient power plant operation, the U.S. Nuclear Regulatory Commission funded research on 8-hr and 12-hr shifts at the Human Alertness Research Center (HARC) in Boston, Massachusetts. This report describes the research undertaken: a study of simulated 8-hr and 12-hr work shifts that compares alertness, speed, and accuracy at responding to simulator alarms, and relative cognitive performance, self-rated mood and vigor, and sleep-wake patterns of 8-hr versus 12-hr shift workers.

  7. Verification and Validation of Digitally Upgraded Control Rooms

    Energy Technology Data Exchange (ETDEWEB)

    Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lau, Nathan [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    As nuclear power plants undertake main control room modernization, a challenge is the lack of a clearly defined human factors process to follow. Verification and validation (V&V) as applied in the nuclear power community has tended to involve efforts such as integrated system validation, which comes at the tail end of the design stage. To fill in guidance gaps and create a step-by-step process for control room modernization, we have developed the Guideline for Operational Nuclear Usability and Knowledge Elicitation (GONUKE). This approach builds on best practices in the software industry, which prescribe an iterative user-centered approach featuring multiple cycles of design and evaluation. Nuclear regulatory guidance for control room design emphasizes summative evaluation—which occurs after the design is complete. In the GONUKE approach, evaluation is also performed at the formative stage of design—early in the design cycle using mockups and prototypes for evaluation. The evaluation may involve expert review (e.g., software heuristic evaluation at the formative stage and design verification against human factors standards like NUREG-0700 at the summative stage). The evaluation may also involve user testing (e.g., usability testing at the formative stage and integrated system validation at the summative stage). An additional, often overlooked component of evaluation is knowledge elicitation, which captures operator insights into the system. In this report we outline these evaluation types across design phases that support the overall modernization process. The objective is to provide industry-suitable guidance for steps to be taken in support of the design and evaluation of a new human-machine interface (HMI) in the control room. We suggest the value of early-stage V&V and highlight how this early-stage V&V can help improve the design process for control room modernization. We argue that there is a need to overcome two shortcomings of V&V in current practice

  8. Effects of Intervention and Team Culture on Operating Room Traffic.

    Science.gov (United States)

    Pulido, Ricardo W; Kester, Benjamin; Schwarzkopf, Ran

    How changes in the surgical team's culture can potentially reduce operating room (OR) traffic. Excessive OR traffic during surgical procedures can present a risk to the patient's safety and recovery. Data suggest that limiting the number of OR personnel during the intraoperative period can reduce excessive OR traffic. However, it is unclear whether the surgeon's verbal intervention can also successfully reduce intraoperative OR traffic. This study compares traffic rates in hip and knee arthroplasty cases against traffic rates during nonarthroplasty cases to examine the effects of verbal interventions implemented by the surgeon to reduce intraoperative traffic. The study consisted of 16 orthopedic surgeons in a noninterventional group and 1 orthopedic surgeon in the interventional group. The surgeon in the interventional group implemented verbal protocols to OR staff to limit excessive intraoperative traffic. Operating room traffic was monitored for 3 consecutive months (January-March 2015) with the use of infrared automated door counters that tracked door openings when someone entered or left the OR. A total of 50 hip and knee arthroplasties cases and 157 nonarthroplasty cases were tracked during the study period. A total of 134 hours and 4482 movements were collected for the hip and knee arthroplasty cases. A total of 498 hours and 22 902 movements were collected for the nonarthroplasty cases. Comparing the 2 groups, the interventional group averaged 33 movements per hour while the noninterventional group averaged 46 movements per hour (P traffic can be reduced through simple verbal protocols established by the surgical team.

  9. A Research Framework for Demonstrating Benefits of Advanced Control Room Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Le Blanc, Katya [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hallbert, Bruce [Idaho National Lab. (INL), Idaho Falls, ID (United States); Thomas, Kenneth [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-12-01

    Control Room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. A full-scale modernization might, for example, entail replacement of all analog panels with digital workstations. Such modernizations have been undertaken successfully in upgrades in Europe and Asia, but the U.S. has yet to undertake a control room upgrade of this magnitude. Instead, nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digital modernizations. Previous research under the U.S. Department of Energy’s Light Water Reactor Sustainability Program has helped establish a systematic process for control room upgrades that support the transition to a hybrid control. While the guidance developed to date helps streamline the process of modernization and reduce costs and uncertainty associated with introducing digital control technologies into an existing control room, these upgrades do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The aim of the control room benefits research presented here is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report serves as an outline for planned research on the benefits of greater modernization in the main control rooms of nuclear power plants.

  10. Emergency control room design of a nuclear reactor used to produce radioisotope

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Isaac J.A.L. dos; Farias, Larissa P. de; Ponte, Luana T.L.; Goncalves, Gabriel L.; Castro, Heraclito M.; Farias, Marcos S.; Carvalho, Paulo V.R. de; Vianna Filho, Alfredo M.V., E-mail: luquetti@ien.gov.br [Instituto Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Departamento Engenharia Nuclear

    2015-07-01

    A control room is defined as a functional entity with an associated physical structure, where the operators carry out the centralized control, monitoring and administrative responsibilities. Emergency control room acts as an alternative control room for the purpose of shutting down or maintaining the facility in a safe shutdown state when the main control room is uninhabitable. The mission of emergency control room is to provide the resources to bring the plant to a safe shutdown condition after an evacuation of the main control room. An evacuation of the main control room is assumed when there is no possibility to accomplish tasks involved in the shutdown except reactor trip. The purpose of this paper is to present a specific approach for the design of the emergency control room of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards and the participation of a multidisciplinary team in the development phase of the design. Using the information gathered from standards and from the multidisciplinary team a 3D Sketch and a 3D printing of the emergency control room were created. (author)

  11. Capturing Control Room Simulator Data with the HERA Database

    Energy Technology Data Exchange (ETDEWEB)

    Ronald Boring; April Whaley; Bruce Hallbert; Karin Laumann; Per Oivind Braarud; Andreas Bye; Erasmia Lois; Yung Hsien James Chang

    2007-08-01

    The Human Event Repository and Analysis (HERA) system has been developed as a tool for classifying and recording human performance data extracted from primary data sources. This paper reviews the process of extracting data from simulator studies for use in HERA. Simulator studies pose unique data collection challenges, both in types and quality of data measures, but such studies are ideally suited to gather operator performance data, including the full spectrum of performance shaping factors used in a HERA analysis. This paper provides suggestions for obtaining relevant human performance data for a HERA analysis from a control room simulator study and for inputting those data in a format suitable for HERA.

  12. Preparedness of Operation Teams' Non-technical Skills in a Main Control Room of Nuclear Power Plants to Manage Emergency Situations

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Ho Bin; Kim, Ar Ryum; Seong, Poong Hyun [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    Human reliability is one of the important determinants for the system safety. Nuclear Energy Agency reported that approximately half of events reported by foreign nuclear industry were related with inappropriate human actions. The human error problems can be viewed in two ways: the person approach and the system approach. Other terms to represent each approach are active failures and latent conditions. Active failures are unsafe acts committed by people who are in direct contact with systems whereas latent conditions are the inevitable 'resident pathogens' within the system. To identify what kinds of non-technical skills were needed to cope with emergency conditions, a method to evaluate preparedness of task management in emergency conditions based on monitoring patterns was presented. Five characteristics were suggested to evaluate emergency task management and communication: latent mistake resistibility, latent violation resistibility, thoroughness, communication, and assertiveness. Case study was done by analyzing emergency training of 9 different real operation teams in the reference plant. The result showed that the 9 teams had their own emergency task management skills which resulted in good and bad performances

  13. Shielding considerations for an operating room based intraoperative electron radiotherapy unit.

    Science.gov (United States)

    Mills, M D; Almond, P R; Boyer, A L; Ochran, T G; Madigan, W; Rich, T A; Dally, E B

    1990-05-01

    The leakage radiation characteristics of a dedicated intraoperative radiotherapy linear accelerator have been measured on a machine designed to minimize the shielding required to allow it to be placed in an operating room suite. The scattering foil design was optimized to produce a flat beam for the field sizes employed while generating minimal bremsstrahlung contamination over the available energy range. More lead shielding was used in the treatment head than is used in conventional accelerators. A small amount of borated polyethylene shielding was also employed since neutron production was present at measurable levels. The room shielding installed in the operating room was demonstrated to be adequate to treat at least 20 patients each month to an average dose of 20 Gy. The worst case exposure was found to be 73% maximum permissible exposure. Administrative control was required for adjoining areas when calibrations and maintenance were performed.

  14. The effect of Quality Control Circle(QCC)in improving the cooperation ability of nurses in operation room%品管圈在提高手术室护士手术配合能力中的应用

    Institute of Scientific and Technical Information of China (English)

    胡敏

    2016-01-01

    Objective:To explorer effects of quality control cycle improving the cooperation ability of nurses in operation room. Methods:8 nurses in operation room of our hospital were selected to set up quality control cycle. Scores of communications between nurses and doctors, theoretic knowledge and professional skills of medical emergency were observed and compared before and after the implement of QCC. Results:After the implement of QCC, all scores of communications between nurses and doctors, theoretic knowledge and professional skills of medical emergency were higher than before, and all differences were signiifcant(P<0.05). Conclusion:The implement of QCC could effectively reinforce the theoretical knowledge of medical emergency, improve the level of professional skills, strengthen the communication between nurses and doctors, and ensure the operation to carry on successfully.%目的:探讨品管圈在提高手术室护士手术配合能力的作用效果。方法选取我院手术室的8名护士组成品管圈,比较品管圈实施前后护士在医护沟通、急救理论知识和急救操作技能的评分情况。结果实施品管圈后,护士在医护沟通、急救理论知识和急救操作技能方面的评分均高于实施前,前后比较,差异具有统计学意义(P<0.05)。结论品管圈活动可以有效夯实护士的理论知识,提高专业技能操作水平,强化医护的沟通,保证手术的顺利进行。

  15. How do strategic decisions and operative practices affect operating room productivity?

    Science.gov (United States)

    Peltokorpi, Antti

    2011-12-01

    Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

  16. Utilization of operating room time in a cancer hospital

    Directory of Open Access Journals (Sweden)

    P Ranganathan

    2013-01-01

    Full Text Available Background: Appropriate usage of operating room (OR time can improve efficiency of utilization of resources and help to decrease surgical waiting lists. Aims: This study was conducted to evaluate the pattern of usage of OR time in a tertiary referral cancer hospital. Setting and Design: This was a prospective audit carried out over 2 months in 11 major ORs in a cancer hospital. Materials and Methods: OR anesthesiologists filled a standard form for all patients undergoing elective surgery and documented the following times: entry into OR, start of anesthesia, handover to surgeon, incision, start of reversal, end of anesthesia, and shifting out of patient. Statistical Analysis: Median time utilized for various OR processes was calculated. Results: An average of two surgeries were performed per OR session (828 surgeries in 407 OR sessions. Anesthesia and surgery-related processes contributed to 17% and 79%, respectively, of total OR time, with turnover time between cases accounting for the remaining 4%. Fifteen percent (60 out of 407 OR sessions started more than 10 min later than the planned start time, and 17% (70 of 407 of OR sessions ended more than 2 h after the scheduled finish time. An anesthesia procedure room was utilized in only 15% of cases where it could potentially have been used. Conclusion: This audit identified patterns of OR usage in a cancer hospital and helped to detect areas of inefficient utilization. Anesthesia-related processes contributed to 17% of the total OR time.

  17. Gender, patient comfort and the neurosurgical operating room.

    Science.gov (United States)

    Zener, Rebecca; Bernstein, Mark

    2011-01-01

    Neurosurgical patients may be unaware of components of their intra-operative care. The relationship between patient gender and comfort level in the neurosurgical operating room (OR) has not been previously studied. Our objective was to gain insight into patients' perspective of the OR environment, including staffing and observers, the role of medical students, catheterization, exposure, and verbiage, using a qualitative needs assessment. Face-to-face semi-structured interviews were conducted with 20 patients (14 female, six male) who had a neurosurgical operation under general anesthetic within the previous two years. The majority underwent craniotomy for benign tumours. Interviews were transcribed and subjected to modified thematic analysis. Nine themes emerged: 1) perception of the intra-operative environment varies between men and women; 2) lacking awareness about observers is anxiety-provoking for women; 3) being unaware of the hands-on involvement of students is a concern for all patients; 4) disclosure of implantation of foreign and permanent materials into patients is important; 5) catheterization is anxiety provoking for women; 6) pre-operative menstruation screening may minimize embarrassment for women; 7) patients perceive extraneous conversation as a distraction for surgeons; 8) patients trust their surgeon; 9) a relationship exists between interviewer gender and patient comfort in the interview. Although most male and female patients are unaware of OR activities, they are generally not fearful since they trust their surgeon. Women appear to have greater information needs. Patients' information needs must be met without provoking anxiety and yet preserving their personal sense of modesty in the intra-operative environment.

  18. To the point: teaching the obstetrics and gynecology medical student in the operating room.

    Science.gov (United States)

    Hampton, Brittany S; Craig, LaTasha B; Abbott, Jodi F; Buery-Joyner, Samantha D; Dalrymple, John L; Forstein, David A; Hopkins, Laura; McKenzie, Margaret L; Page-Ramsey, Sarah M; Pradhan, Archana; Wolf, Abigail; Graziano, Scott C

    2015-10-01

    This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of considerations for teaching the medical student in the operating room during the obstetrics/gynecology clerkship. The importance of the medical student operating room experience and barriers to learning in the operating room are discussed. Specific considerations for the improvement of medical student learning and operating room experience, which include the development of operating room objectives and specific curricula, an increasing awareness regarding role modeling, and faculty development, are reviewed.

  19. Implementation of a risk management plan in a hospital operating room

    Directory of Open Access Journals (Sweden)

    Li Guo

    2015-12-01

    Full Text Available A risk management program based on AS–NZS4360 risk management standards was developed and implemented in the operating room of Peking University Third Hospital. To accomplish this task, we developed a risk quantification matrix and a risk register form to identify potential risks in the operating room, and then implemented operating room policies designed to reduce or eliminate those risks. We also established a consultation mechanism and risk monitoring system designed to minimize risks to operation room nurses. Finally, we continuously seek to improve our operating room risk management capabilities, so we can continue to improve the quality of service provided and guarantee the safety of surgical patients.

  20. Music in the operating room: is it a safety hazard?

    Science.gov (United States)

    Shambo, Lyda; Umadhay, Tony; Pedoto, Alessia

    2015-02-01

    Noise is a health hazard and a source of stress, and it impairs concentration and communication. Since 1960, hospital noise levels have risen around the world. Nowhere in the healthcare setting is noise more prevalent than in the operating room (OR). The genetic makeup of humans does not evolve at the rate of technology. Noise exposure, sensory overload, and the capacity to adapt without physical and psychological consequences are absent from the human condition. The World Health Organization has recognized environmental noise as harmful pollution that causesadverse effects on health. Although noise in the OR is unavoidable, music is a choice. The purpose of this literature review is to provide further insight into the ramifications of the presence of music in the OR, evaluate its appropriateness in relation to care and safety for the patient and staff, and provide information for future research.

  1. CERN's Technical Control Room (TCR) A Central Service for Everyone

    CERN Multimedia

    Mario Batz

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  2. COMMERCIAL UTILITY PERSPECTIVES ON NUCLEAR POWER PLANT CONTROL ROOM MODERNIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Jeffrey C. Joe; Ronald L. Boring; Julius J. Persensky

    2012-07-01

    Commercial nuclear power plants (NPPs) in the United States need to modernize their main control rooms (MCR). Many NPPs have done partial upgrades with some success and with some challenges. The Department of Energy’s (DOE) Light Water Reactor Sustainability (LWRS) Program, and in particular the Advanced Instrumentation and Controls (I&C) and Information Systems Technologies Research and Development (R&D) Pathway within LWRS, is designed to assist commercial nuclear power industry with their MCR modernization efforts. As part of this framework, a survey was issued to utility representatives of the LWRS Program Advanced Instrumentation, Information, and Control Systems/Technologies (II&C) Utility Working Group to obtain their views on a range of issues related to MCR modernization, including: drivers, barriers, and technology options, and the effects these aspects will have on concepts of operations, modernization strategies, and staffing. This paper summarizes the key survey results and discusses their implications.

  3. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz / TCR Responsible

    2000-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number 72201. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the tec...

  4. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz (TCR Responsible)

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number 72201. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the tec...

  5. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz (TCR Responsible)

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  6. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2002-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate CERN equipment services or contractors. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity covers the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, and buildings. These systems can either be part of the administrative infrastructure, such as offices or restaur...

  7. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2002-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  8. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRALSERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz / TCR Responsible

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  9. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  10. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2002-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate CERN equipment services or contractors. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity covers the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, and buildings. These systems can either be part of the administrative infrastructure, such as offices or restaur...

  11. 质量控制小组管理模式在手术室护理管理中的应用分析%Application Analysis of Quality Control Team Management on Nursing Management in the Operating Room

    Institute of Scientific and Technical Information of China (English)

    吴娟娟

    2016-01-01

    目的:探析质量控制小组管理模式在手术室护理管理中的应用效果。方法选取我科720台手术操作,设立质量控制小组后,观察护理质量控制平均评分及不良事件发生率。结果实行质量控制管理后,护理质量和不良事件发生率均优于实施前(P<0.05)。结论质量控制小组管理模式的实施,可培养护理人员的管理能力,从而提高护理质量,减少不良事件发生率。%Objective Analysis of the quality control team management in the operating room nursing management.Methods Chose 720 surgical procedures,seting up quality control team to observe the quality of care and controling the average score after the incidence of adverse events.Results After the implementation of quality control management,quality of care and adverse events were significantly better than before(P<0.05).Conclusion The implementation of quality control team management mode,nurses can train management capabilities,thus improve the quality of care, reduce the incidence of adverse events.

  12. Methodology for the identification of the factors that can influence the performance of operators of nuclear power plants control room under emergency situations; Metodologia para identificacao dos fatores que afetam o desempenho dos operadores de salas de controle de plantas nucleares, em situacoes de emergencia

    Energy Technology Data Exchange (ETDEWEB)

    Paiva, Bernardo Spitz; Santos, Isaac J.A. Luquetti, E-mail: bernardo_spitz@hotmail.co, E-mail: luquetti@ien.gov.b [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    In order to minimize the human errors of the operators in a nuclear power plan control room, during emergency situations, it has to be considered the factors which affect the human performance. Work situations adequately projected, compatible with the necessities, capacities and human limitations, taking into consideration the factors which affect the operator performance . This paper aims to develop a methodology for identification of the factors affecting the operator performance under emergency situation, using the aspects defined by the human reliability analysis focusing the judgment done by specialists

  13. Methodology for analyzing environmental quality indicators in a dynamic operating room environment.

    Science.gov (United States)

    Gormley, Thomas; Markel, Troy A; Jones, Howard W; Wagner, Jennifer; Greeley, Damon; Clarke, James H; Abkowitz, Mark; Ostojic, John

    2017-04-01

    Sufficient quantities of quality air and controlled, unidirectional flow are important elements in providing a safe building environment for operating rooms. To make dynamic assessments of an operating room environment, a validated method of testing the multiple factors influencing the air quality in health care settings needed to be constructed. These include the following: temperature, humidity, particle load, number of microbial contaminants, pressurization, air velocity, and air distribution. The team developed the name environmental quality indicators (EQIs) to describe the overall air quality based on the actual measurements of these properties taken during the mock surgical procedures. These indicators were measured at 3 different hospitals during mock surgical procedures to simulate actual operating room conditions. EQIs included microbial assessments at the operating table and the back instrument table and real-time analysis of particle counts at 9 different defined locations in the operating suites. Air velocities were measured at the face of the supply diffusers, at the sterile field, at the back table, and at a return grille. The testing protocol provided consistent and comparable measurements of air quality indicators between institutions. At 20 air changes per hour (ACH), and an average temperature of 66.3°F, the median of the microbial contaminants for the 3 operating room sites ranged from 3-22 colony forming units (CFU)/m(3) at the sterile field and 5-27 CFU/m(3) at the back table. At 20 ACH, the median levels of the 0.5-µm particles at the 3 sites were 85,079, 85,325, and 912,232 in particles per cubic meter, with a predictable increase in particle load in the non-high-efficiency particulate air-filtered operating room site. Using a comparison with cleanroom standards, the microbial and particle counts in all 3 operating rooms were equivalent to International Organization for Standardization classifications 7 and 8 during the mock surgical

  14. OVERVIEW OF A RECONFIGURABLE SIMULATOR FOR MAIN CONTROL ROOM UPGRADES IN NUCLEAR POWER PLANTS

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring

    2012-10-01

    This paper provides background on a reconfigurable control room simulator for nuclear power plants. The main control rooms in current nuclear power plants feature analog technology that is growing obsolete. The need to upgrade control rooms serves the practical need of maintainability as well as the opportunity to implement newer digital technologies with added functionality. There currently exists no dedicated research simulator for use in human factors design and evaluation activities for nuclear power plant modernization in the U.S. The new research simulator discussed in this paper provides a test bed in which operator performance on new control room concepts can be benchmarked against existing control rooms and in which new technologies can be validated for safety and usability prior to deployment.

  15. Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.

    Science.gov (United States)

    Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien

    2016-05-01

    Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  16. Indoor environmental quality in Hellenic hospital operating rooms

    Energy Technology Data Exchange (ETDEWEB)

    Dascalaki, Elena G.; Gaglia, Athina G.; Balaras, Constantinos A. [Group Energy Conservation, Institute for Environmental Research and Sustainable Development, National Observatory of Athens, I. Metaxa and Vas. Pavlou, GR 152 36 P. Penteli (Greece); Lagoudi, Argyro [Terra Nova Ltd., Environmental Engineering Consultancy, Athens, Kaisareias 39, GR 115 27 Athens (Greece)

    2009-05-15

    Indoor environmental quality (IEQ) in hospital operating rooms (ORs) constitutes a major challenge for the proper design and operation of an energy efficient hospital. A subjective assessment of the indoor environment along with a short monitoring campaign was performed during the audits of 18 ORs at nine major Hellenic hospitals. A total of 557 medical personnel participated in an occupational survey, providing data for a subjective assessment of IEQ in the audited ORs. The OR personnel reported work related health symptoms and an assessment of indoor conditions (thermal, visual and acoustical comfort, and air quality). Overall, personnel reported an average of 2.24 work-related symptoms each, and 67.2% of respondents reported at least one. Women suffer more health symptoms than men. Special dispositions, such as smoking and allergies, increase the number of reported symptoms for male and female personnel. Personnel that perceive satisfactory indoor comfort conditions (temperature, humidity, ventilation, light, and noise) average 1.18 symptoms per person, while for satisfactory indoor air quality the average complaints are 0.99. The perception of satisfactory IEQ (satisfactory comfort conditions and air quality) reduces the average number of health complaints to 0.64 symptoms per person and improves working conditions, even in a demanding OR environment. (author)

  17. A Business Case for Nuclear Plant Control Room Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Ken [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lawrie, Sean [Idaho National Lab. (INL), Idaho Falls, ID (United States); Niedermuller, Josef M. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-06-01

    This paper presents a generic business case for implementation of technology that supports Control Room Modernization (CRM). The analysis presented in two forms; 1) a standalone technology upgrade, and 2) a technology upgrade that is built upon and incremental to a prior business case created for Mobile Work Packages (MWP). The business case contends that advanced communication and networking and analytical technologies will allow NPP to conduct control room operations with improved focus by reducing human factors and redundant manpower, and therefore operate with fewer errors. While some labor savings can be harvested in terms of overtime, the majority of savings are demonstrated as reduced time to take the plant off line and bring back on line in support of outages. The benefits are quantified to a rough order of magnitude that provides directional guidance to NPPs that are interested in developing a similar business case. This business case focuses on modernization of the operator control room and does not consider a complete overhaul and modernization of a plants instrument and control systems. While operators may be considering such an investment at their plants, the sizable capital investment required is not likely supported by a cost/benefit analysis alone. More likely, it is driven by obsolescence and reliability issues, and requires consideration of mechanical condition of plant systems, capital depreciation, financing, relicensing and overall viability of the plant asset over a 20-year horizon in a competitive market. Prior studies [REF] have indicated that such a modernization of plant I&C systems, alone or as part of a larger modernization effort, can yield very significant reductions in O&M costs. However, the depth of research and analysis required to develop a meaningful business case for a plant modernization effort is well beyond the scope of this study. While CRM as considered in this study can be easily integrated as part of grander plant

  18. [Simulation-based analysis of novel therapy principles. Effects on the efficiency of operating room processes].

    Science.gov (United States)

    Baumgart, A; Denz, C; Bender, H; Bauer, M; Hunziker, S; Schüpfer, G; Schleppers, A

    2009-02-01

    The introduction of innovative drugs in anesthesiological treatment has the potential to improve perioperative efficiency. This article examines the impact of the new muscle relaxant encapsulator Bridion on emergence from anesthesia and on the efficiency of the perioperative organization. To analyze the effects of medical innovations, computer simulation was used as an experimental frame. The simulation was based on a realistic model of an operating room setting and used historical data to study the effect of innovation on the operational performance and the economic outcomes. The use of medical innovations in anesthesiological emergence yields new potentials for a hospital under certain conditions. Due to shorter block times and anesthesia-controlled times, additional benefits for the operating room could be realized. This results in an increase of up to 2.4% additional cases during similar working hours and planning periods. The introduction of innovative medicines may reveal more efficient and economical conditions in operating rooms. The overall result depends, for example, on the rate of application of the patient's portfolio or the organization and access rules of the surgical suite. Based on the anesthesia-controlled time no general a priori statement about the economic potentials can be confirmed. Future empirical studies should investigate the impact on quality and economic benefits for the entire patient pathway.

  19. Measuring Human Performance in Simulated Nuclear Power Plant Control Rooms Using Eye Tracking

    Energy Technology Data Exchange (ETDEWEB)

    Kovesdi, Casey Robert [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rice, Brandon Charles [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bower, Gordon Ross [Idaho National Lab. (INL), Idaho Falls, ID (United States); Spielman, Zachary Alexander [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hill, Rachael Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States); LeBlanc, Katya Lee [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-11-01

    Control room modernization will be an important part of life extension for the existing light water reactor fleet. As part of modernization efforts, personnel will need to gain a full understanding of how control room technologies affect performance of human operators. Recent advances in technology enables the use of eye tracking technology to continuously measure an operator’s eye movement, which correlates with a variety of human performance constructs such as situation awareness and workload. This report describes eye tracking metrics in the context of how they will be used in nuclear power plant control room simulator studies.

  20. POST OPERATIVE PROBLEMS IN ORTOPEDICS PATIENTS IN THE RECOVERY ROOM

    Directory of Open Access Journals (Sweden)

    Regiane Aparecida dos Santos Soares Barreto

    2002-12-01

    Full Text Available This study aimed at providing related problems in patients who had undergone orthopedic surgery through theevaluation of the following variables: sex, age, surgery type and anesthesia type. Two hundred and twenty patientswere studied. They had been submitted to an elective orthopedic surgical procedure from July to December 1998and their medical records were used for retrospective data collection. With regard to sex, 58% were males and42% were females. As to age, middle-aged patients - 35 to 65 years old - comprised 48%, young adults - 18 to 35years old - were 38% and elderly adults - over 66 years old - were 14%. The frequency of results were as follows:surgery on the upper limbs/shoulder, 27%, knee/leg, 32%, spinal cord, 17%, femur/hips, 15%, ankle/foot, 9%,regional anesthesia, 48%, general anesthesia, 38%, regional associated with general, 6% and blocking, 8%.Occurred 306 post-operative problems were observed as follows: pain, 45%, nausea/vomiting, 16%, blooding,11%, cardiovascular alterations, 10%, hypothermia, 9%, urinary retention, 5%, respiratory problems, 1% andhiperthermia, 0,6%. In this way, there was an attempt at making a profile of orthopedic surgery patients in POI as asource of data for planning nursing care. It is believed that the study has contributed to nursing care in postanesthesiarecovery room which is based on scientific data and not only on every-day practice.

  1. A Miracle That Accelerates Operating Room Functionality: Sugammadex

    Directory of Open Access Journals (Sweden)

    Erdal Dogan

    2014-01-01

    Full Text Available Background. Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape. Methods. In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF <0.9 with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered. Results. Time elapsed until sugammadex administration following neostigmine 37 ± 6 min, following sugammadex it took 2.1 ± 0.9 min to reach TOF ≥ 0.9, and the extubation time was 3.2 ± 1.4 min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period. Conclusion. Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient.

  2. Decision support system for the operating room rescheduling problem.

    Science.gov (United States)

    van Essen, J Theresia; Hurink, Johann L; Hartholt, Woutske; van den Akker, Bernd J

    2012-12-01

    Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

  3. Technologies and solutions for data display in the operating room.

    Science.gov (United States)

    Bitterman, Noemi

    2006-06-01

    Recent advances in technology have led to the introduction of a variety of innovative devices, each with their own platform for data display, into the operating room (OR). While these innovative applications are expanding the traditional boundaries of the surgical space and enhancing treatment capabilities, the introduction of additional screens and displays is placing an ever-increasing load on the OR team. This review describes the main data display platforms currently available in ORs: computer monitors with CRT (cathode ray tube) or LCD (liquid crystal display) screens, suspended imaging displays, wearable computers (WC), auditory displays and tactile (haptic) displays. The different display platforms are evaluated according to their compatibility with the characteristics of the working environment (OR), the monitoring task, and the users (the surgical team). No single display configuration provides an ultimate solution for presenting patient data in the OR. A multi-sensory data display including visual, acoustic and haptic manipulation is suggested as a promising configuration for data display in the OR.

  4. The operating room: architectural conditions and potential hazards.

    Science.gov (United States)

    Koneczny, Sonja

    2009-01-01

    Ergonomics is still not fully implemented in the design of operation rooms (ORs). The OR staff has to deal with various ergonomic deficiencies which may be associated with potential hazards for the patient and/or the OR team.Three surveys were conducted among German OR staff at major conferences. Two of them dealt with the working conditions in the OR and were conducted among surgeons and OR nurses. The third survey queried OR nurses about the electrical safety in the OR.In addition, a specially developed checklist was used to evaluate the work place OR in five German OR units and the staff of these OR units were queried with questionnaires adapted from the surveys. For this article a few of the deficiencies found in the ORs were chosen to serve as examples for the plethora of results gathered.Findings showed that there was a high potential for ergonomic improvement and therefore an increase in safety and comfort. Many of these deficiencies may be eased by simple means such as the reduction of the number of different devices and mandatory training in the use of the devices since device operation is one of the main causes leading to potential hazards in the OR. Other deficiencies, such as the cable routing in the OR, require more extensive intervention and/or the implementation of new techniques, for example the "wireless" OR. All these deficiencies demonstrate the need for better implementation of ergonomics into the OR and for individual solutions, as there is no such thing as an 'one-size-fits-all' solution for OR units.

  5. Impact of integrated control on nosocomial infections in patients of gynecological outpatient operating rooms%综合控制对妇科手术患者医院感染的影响

    Institute of Scientific and Technical Information of China (English)

    李世红; 王苏荣; 孟琴; 刘天凤; 李彦华

    2015-01-01

    OBJECTIVE To explore the impact of integrated control program on incidence of nosocomial infections in the patients of gynecological outpatient operating rooms so as to reduce the incidence of clinical infections . METHODS A total of 2 200 patients who were treated in the gynecology department and discharged from Jan 2012 to Jan 2013 were selected as the control group ,the characteristics of the patients with postoperative infections were analyzed so as to formulate the integrated control program ,subsequently ,the integrated control program was adopted in the gynecology department from Feb 2013 to Feb 2014 ,and 2 200 discharged patients were assigned as the observation group so as to conduct the retrospective survey ;the qualified rates of theoretical knowledge and operation skills of the health care workers and the incidence of postoperative infections were observed and com‐pared before and after the integrated control program was implemented .RESULTS The age ,infection sites ,and length of hospital stay were the risk factors associated with nosocomial infections in the patients .The qualified rates of both the theoretical knowledge assessment and operation skill assessment were significantly improved after the integrated control program was implemented (P<0 .01) .As compared with the prevalence of infections before and after the integrated control program was implemented ,the incidence of postoperative nosocomial infections was 9 .86% in the control group ,1 .95% in the observation group ,and the infection rate was significantly reduced after the integrated control program was implemented (P<0 .01) .CONCLUSION The integrated control program may help to improve the reasonable area distribution of the gynecological outpatient operating room ,ensure that the doctors make checks at all levels ,and intensify the awareness of sterilization of the health care workers so as to effectively reduce the incidence of nosocomial infections after the gynecologic surgery .%

  6. Changing Operating Room Culture: Implementation of a Post-Operative Debrief and Improved Safety Culture.

    Science.gov (United States)

    Magill, Stephen T; Wang, Doris D; Rutledge, W Caleb; Lau, Darryl; Berger, Mitchel S; Sankaran, Sujatha; Lau, Catherine Y; Imershein, Sarah G

    2017-08-23

    Patient safety is foundational to neurosurgical care. Post-procedural "debrief" checklists have been proposed to improve patient safety, but there is limited data about their use in neurosurgery. Here, we implemented an initiative to routinely perform post-operative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical operating room staff at a major academic medical center before and 18-months after implementation of a post-operative debriefing initiative. Rates of debrief compliance and changes in attitudes before and after the survey were evaluated. The survey utilized a Likert scale and analyzed with standard statistical methods. After the debrief initiative, the rate of debriefing increased from 51% to 86% of cases for the neurosurgery service. Baseline SAQ responses found that neurosurgeons had a more favorable perception of OR safety than anesthesiologists and nurses. Following implementation of the post-operative debriefing process, perceptions of OR safety significantly improved for neurosurgeons, anesthesiologists and nurses. Furthermore, the disparity between nurses and surgeons was no longer significant. After debrief implementation, neurosurgical OR staff had improved perceptions of patient safety compared to surgical services that did not commonly perform debriefing. Debriefing identified OR efficiency concerns in 26.9% of cases and prevention of potential adverse events/near misses were reported in 8% of cases. Post-operative debriefing can be effectively introduced into the operating room and improves the safety culture after implementation. Debriefing is an effective tool to identify OR inefficiencies and potential adverse events. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. High-density magnetoresistive random access memory operating at ultralow voltage at room temperature.

    Science.gov (United States)

    Hu, Jia-Mian; Li, Zheng; Chen, Long-Qing; Nan, Ce-Wen

    2011-11-22

    The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch(-2), ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns.

  8. HFE safety reviews of advanced nuclear power plant control rooms

    Science.gov (United States)

    Ohara, John

    1994-01-01

    Advanced control rooms (ACR's) will utilize human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator's overall role and means of interacting with the system. The Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) aspects of HSI's to ensure that they are designed to good HFE principles and support performance and reliability in order to protect public health and safety. However, the only available NRC guidance was developed more than ten years ago, and does not adequately address the human performance issues and technology changes associated with ACR's. Accordingly, a new approach to ACR safety reviews was developed based upon the concept of 'convergent validity'. This approach to ACR safety reviews is described.

  9. Testing Efficiency Improved by Addition of Remote Access Control Room

    Science.gov (United States)

    1996-01-01

    The NASA Lewis Research Center's Remote Access Control Room (RACR) uses off-the-shelf video conferencing software integrated with existing facility data systems to provide access to the test data by networking from virtually anywhere in the country. The system allows research engineers in remote locations to participate in tests and monitor data in real time just as if they were present in the control room.

  10. [Conflict matrix : Risk management tool in the operating room].

    Science.gov (United States)

    Andel, D; Markstaller, K; Andel, H

    2017-05-01

    In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team. This inevitably leads to the emergence and escalation of conflicts. We developed a conflict matrix to provide an inexpensive and objective way for evaluating the level of escalation of conflicts in a multiprofessional working environment, such as an OR. The senior members of all involved disciplines were asked to estimate the level of conflict escalation between the individual professional groups on a scale of 0-9. By aggregating the response data, an overview of the conflict matrix within this OR section was created. No feedback was received from 1 of the 11 contacted occupational groups. By color coding the median, minimum and maximum values of the retrieved data, an intuitive overview of the escalation levels of conflict could be provided. The value range of all feedbacks was between 0 and 6. Estimation of the escalation levels differed widely within one category, showing a range of up to 6 (out of 6) levels. The presented assessment using a conflict matrix is a simple and cost-effective method to assess the conflict landscape, especially in multidisciplinary environments, such as OR management. The chance of conflict prevention or the early recognition of existing conflicts represents an enormous potential for cost and risk saving and might have positive long-term effects by building a culture of conflict prevention at the workplace and a positive influence on interdisciplinary cooperation in this working environment.

  11. Operating room waste reduction in plastic and hand surgery

    Science.gov (United States)

    Albert, Mark G; Rothkopf, Douglas M

    2015-01-01

    BACKGROUND: Operating rooms (ORs), combined with labour and delivery suites, account for approximately 70% of hospital waste. Previous studies have reported that recycling can have a considerable financial impact on a hospital-wide basis; however, its importance in the OR has not been demonstrated. OBJECTIVE: To propose a method of decreasing cost through judicious selection of instruments and supplies, and initiation of recycling in plastic and hand surgery. METHODS: The authors identified disposable supplies and instruments that are routinely opened and wasted in common plastic and hand surgery procedures, and calculated the savings that can result from eliminating extraneous items. A cost analysis was performed, which compared the expense of OR waste versus single-stream recycling and the benefit of recycling HIPAA documents and blue wrap. RESULTS: Fifteen total items were removed from disposable plastic packs and seven total items from hand packs. A total of US$17,381.05 could be saved per year from these changes alone. Since initiating single-stream recycling, the authors’ institution has saved, on average, US$3,487 per month at the three campuses. After extrapolating at the current savings rate, one would expect to save a minimum of US$41,844 per year. DISCUSSION: OR waste reduction is an effective method of decreasing cost in the surgical setting. By revising the contents of current disposable packs and instrument sets designated for plastic and hand surgery, hospitals can reduce the amount of opened and unused material. CONCLUSIONS: Significant financial savings and environmental benefit can result from this judicious supply and instrument selection, as well as implementation of recycling. PMID:26665137

  12. Operating room waste: disposable supply utilization in neurosurgical procedures.

    Science.gov (United States)

    Zygourakis, Corinna C; Yoon, Seungwon; Valencia, Victoria; Boscardin, Christy; Moriates, Christopher; Gonzales, Ralph; Lawton, Michael T

    2017-02-01

    OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

  13. Use of quality control circle to reduce incidence of occupational exposure among health care workers of operating rooms%应用品管圈降低手术室医护人员职业暴露研究

    Institute of Scientific and Technical Information of China (English)

    王立军; 高洋; 杨庆艳; 刘焕生; 邱枫; 孙长江

    2015-01-01

    OBJECTIVE To reduce the incidence of occupational exposure among the health care workers of operat‐ing rooms through the quality control circle activity .METHODS The quality control circle group was established ,′to reduce the incidence of occupational exposure among the health care workers of operating rooms′was set as the theme ,the basic tools for comprehensive quality management ,including the PDCA cycle ,brainstorming ,affinity diagram ,checklist ,Gantt chart characteristics to the chart (fishbone diagram) ,and Plato ,were employed to ana‐lyze the current status and causes ,and the countermeasures were formulated and implemented for the quality con‐tinuous improvement .RESULTS The incidence of occupational exposure among the health care workers of operat‐ing rooms was decreased by 69 .5% after the quality control circle activity was conducted in 2014 .The circle mem‐bers showed positive improvement of ability of solving problems ,responsibility ,coordination ability ,self‐confi‐dence ,team cohesiveness ,and enthusiasm .CONCLUSION The quality control circle activity can not only minimize the physical and mental harms induced by the occupational exposure but also improve the quality management abili‐ty and enthusiasm of the circle members .%目的:通过品管圈小组活动,降低手术室医护人员职业暴露的发生率。方法成立品管圈小组,确定以“降低手术室医护人员职业暴露发生率”为主题利用全面质量管理的PDCA循环法、头脑风暴法、亲和图、查检表、甘特图、特性要因图(鱼骨图)、柏拉图等基本工具进行现状及原因分析,拟定对策、组织实施,进行持续质量改进。结果与品管圈活动开展前相比,2014年手术室医护人员职业暴露发生率较2013年下降69.5%;圈员解决问题能力、责任心、沟通协调能力、自信心、团队凝聚力、积极性6个方面均出现了正向的增长。结论通过品管

  14. Ergonomics in the licensing and evaluation of nuclear reactors control room; A ergonomia no licenciamento e na avaliacao de salas de controle de reatores nucleares

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Isaac Jose Antonio Luquetti dos [Instituto de Engenharia Nuclear (IEN), Rio de Janeiro, RJ (Brazil); Vidal, Mario Cesar Rodriguez [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia. Programa de Engenharia de Producao

    2002-07-01

    A nuclear control room is a complex system that controls a thermodynamic process used to produce electrical energy. The operators interact with the control room through interfaces that have significant implications to nuclear plant safety and influence the operator activity. The TMI (Three Mile Island) accident demonstrated that only the anthropometric aspects were not enough for an adequate nuclear control room design. The studies showed that the accident was aggravated because the designers had not considered adequately human factor aspects. After TMI accident, the designers introduce in the nuclear control room development only human factors standards and human factors guidelines. The ergonomics approaches was not considered. Our objective is introduce in nuclear control room design and nuclear control room evaluation, a methodology that. includes human factors standards, human factors guidelines and ergonomic approaches, the operator activity analysis. (author)

  15. Light Water Reactor Sustainability Program A Reference Plan for Control Room Modernization: Planning and Analysis Phase

    Energy Technology Data Exchange (ETDEWEB)

    Jacques Hugo; Ronald Boring; Lew Hanes; Kenneth Thomas

    2013-09-01

    The U.S. Department of Energy’s Light Water Reactor Sustainability (LWRS) program is collaborating with a U.S. nuclear utility to bring about a systematic fleet-wide control room modernization. To facilitate this upgrade, a new distributed control system (DCS) is being introduced into the control rooms of these plants. The DCS will upgrade the legacy plant process computer and emergency response facility information system. In addition, the DCS will replace an existing analog turbine control system with a display-based system. With technology upgrades comes the opportunity to improve the overall human-system interaction between the operators and the control room. To optimize operator performance, the LWRS Control Room Modernization research team followed a human-centered approach published by the U.S. Nuclear Regulatory Commission. NUREG-0711, Rev. 3, Human Factors Engineering Program Review Model (O’Hara et al., 2012), prescribes four phases for human factors engineering. This report provides examples of the first phase, Planning and Analysis. The three elements of Planning and Analysis in NUREG-0711 that are most crucial to initiating control room upgrades are: • Operating Experience Review: Identifies opportunities for improvement in the existing system and provides lessons learned from implemented systems. • Function Analysis and Allocation: Identifies which functions at the plant may be optimally handled by the DCS vs. the operators. • Task Analysis: Identifies how tasks might be optimized for the operators. Each of these elements is covered in a separate chapter. Examples are drawn from workshops with reactor operators that were conducted at the LWRS Human System Simulation Laboratory HSSL and at the respective plants. The findings in this report represent generalized accounts of more detailed proprietary reports produced for the utility for each plant. The goal of this LWRS report is to disseminate the technique and provide examples sufficient to

  16. Exploring Bridge-Engine Control Room Collaborative Team Communication

    Directory of Open Access Journals (Sweden)

    Aditi Kataria

    2015-06-01

    Full Text Available The EC funded CyClaDes research project is designed to promote the increased impact of the human element in shipping across the design and operational lifecycle. It addresses the design and operation of ships and ship systems. One of the CyClaDes’ tasks is to create a crew-centered design case-study examination of the information that is shared between the Bridge and Engine Control Room that helps the crew co-ordinate to ensure understanding and complete interconnected tasks. This information can be provided in various ways, including communication devices or obtained from a common database, display, or even the ship environment (e.g., the roll of the ship. A series of semi-structured interviews were conducted with seafarers of diverse ranks to get a better idea of what communication does, or should, take place and any problems or challenges existing in current operations, as seen from both the bridge and ECR operators’ perspectives. Included in the interview were both the standard communications and information shared during planning and executing a voyage, as well as special situations such as safety/casualty tasks or heavy weather. The results were analyzed in terms of the goals of the communication, the primary situations of interest for communication and collaboration, the communication media used, the information that is shared, and the problems experienced. The results of seafarer interviews are presented in the paper to explore on-board inter-departmental communication.

  17. At the PS Main Control Room

    CERN Multimedia

    1974-01-01

    According to the monitor at the time two operations were going on: fast extraction ej58 to the 2 m bubble chamber, and slow extraction ej62 to the electronics experiments in East Hall. Rudy Ley and Frances Bernasconi stand on the foreground, Guerino Azzoni faces the racks.

  18. Operator's Manual, Boiler Room Operations and Maintenance. Supplement A, Air Pollution Training Institute Self-Instructional Course SI-466.

    Science.gov (United States)

    Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.

    This Operator's Manual is a supplement to a self-instructional course prepared for the United States Environmental Protection Agency. This publication is the Boiler Room Handbook for operating and maintaining the boiler and the boiler room. As the student completes this handbook, he is putting together a manual for running his own boiler. The…

  19. A comprehensive operating room information system using the Kinect sensors and RFID.

    Science.gov (United States)

    Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

    2015-04-01

    Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner.

  20. Review of Methods Related to Assessing Human Performance in Nuclear Power Plant Control Room Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Katya L Le Blanc; Ronald L Boring; David I Gertman

    2001-11-01

    With the increased use of digital systems in Nuclear Power Plant (NPP) control rooms comes a need to thoroughly understand the human performance issues associated with digital systems. A common way to evaluate human performance is to test operators and crews in NPP control room simulators. However, it is often challenging to characterize human performance in meaningful ways when measuring performance in NPP control room simulations. A review of the literature in NPP simulator studies reveals a variety of ways to measure human performance in NPP control room simulations including direct observation, automated computer logging, recordings from physiological equipment, self-report techniques, protocol analysis and structured debriefs, and application of model-based evaluation. These methods and the particular measures used are summarized and evaluated.

  1. Operating Room Traffic: Is There Any Role of Monitoring It?

    Science.gov (United States)

    Parikh, Shital N.; Grice, Salih S.; Schnell, Beverly M.; Salisbury, Shelia R.

    2010-01-01

    Background Operating room (OR) human traffic has been implicated as a cause of surgical site infection. We first observed the normal human traffic pattern in our Pediatric Orthopaedic ORs, then examined the effect of surveillance on that traffic pattern. Methods This study consisted of two phases: phase I sought to observe the OR traffic pattern (number of door swings, maximum and minimum number of OR personnel, number of OR personnel at 30 minute intervals, or changes in nursing, anesthesia or surgeon staff) during surgical cases without OR personnel being notified, and for phase II, the same traffic pattern was monitored with their knowledge. Results 2442 minutes of surgical time were observed in phase I, and 1908 minutes were observed in phase II. There was no difference (p=0.06) in the time between door swings between phase I (1.39 minutes) and phase II (1.70), no difference (p=1.000) in the maximum number of people in the OR between phase I (11.5 people, range: 7–15 people) and phase II (11.5 people, range: 8–20 people), no difference (p=1.000) in the minimum number of people in the OR between phase I (4.67 people, range: 4–6 people) and phase II (4.71 people, range: 3–6 people). There was a difference in the time between door swings (p=0.03) and maximum number of people in the OR (p=0.005) based on length of surgery (less or more than120 minutes). There was no difference in the time between door swings (p=0.11), but there was a difference in the maximum number of people in the OR (p=0.002) based on type of surgery (spine vs. others). Conclusion There was no role of surveillance of human traffic in the OR. To achieve any change in the OR traffic pattern, monitoring alone may not be sufficient; other novel techniques or incentives may need to be considered. PMID:20733430

  2. Operating room clinicians' ratings of workload: a vignette simulation study.

    Science.gov (United States)

    Wallston, Kenneth A; Slagle, Jason M; Speroff, Ted; Nwosu, Sam; Crimin, Kimberly; Feurer, Irene D; Boettcher, Brent; Weinger, Matthew B

    2014-06-01

    Increased clinician workload is associated with medical errors and patient harm. The Quality and Workload Assessment Tool (QWAT) measures anticipated (pre-case) and perceived (post-case) clinical workload during actual surgical procedures using ratings of individual and team case difficulty from every operating room (OR) team member. The purpose of this study was to examine the QWAT ratings of OR clinicians who were not present in the OR but who read vignettes compiled from actual case documentation to assess interrater reliability and agreement with ratings made by clinicians involved in the actual cases. Thirty-six OR clinicians (13 anesthesia providers, 11 surgeons, and 12 nurses) used the QWAT to rate 6 cases varying from easy to moderately difficult based on actual ratings made by clinicians involved with the cases. Cases were presented and rated in random order. Before rating anticipated individual and team difficulty, the raters read prepared clinical vignettes containing case synopses and much of the same written case information that was available to the actual clinicians before the onset of each case. Then, before rating perceived individual and team difficulty, they read part 2 of the vignette consisting of detailed role-specific intraoperative data regarding the anesthetic and surgical course, unusual events, and other relevant contextual factors. Surgeons had higher interrater reliability on the QWAT than did OR nurses or anesthesia providers. For the anticipated individual and team workload ratings, there were no statistically significant differences between the actual ratings and the ratings obtained from the vignettes. There were differences for the 3 provider types in perceived individual workload for the median difficulty cases and in the perceived team workload for the median and more difficult cases. The case difficulty items on the QWAT seem to be sufficiently reliable and valid to be used in other studies of anticipated and perceived clinical

  3. Student Registered Nurse Anesthetists' Atittudes toward and Perceptions of Teamwork in the Operating Room

    Science.gov (United States)

    Heiner, Jeremy S.

    2013-01-01

    Student registered nurse anesthetists are an important part of an operating room team, yet little research has investigated how they perceive teamwork or approach team related issues specific to the operating room. This mixed methods study evaluated junior and senior student registered nurse anesthetists' attitudes toward and perceptions of…

  4. Student Registered Nurse Anesthetists' Atittudes toward and Perceptions of Teamwork in the Operating Room

    Science.gov (United States)

    Heiner, Jeremy S.

    2013-01-01

    Student registered nurse anesthetists are an important part of an operating room team, yet little research has investigated how they perceive teamwork or approach team related issues specific to the operating room. This mixed methods study evaluated junior and senior student registered nurse anesthetists' attitudes toward and perceptions of…

  5. CdZnTe room-temperature semiconductor operation in liquid scintillator

    CERN Document Server

    Stewart, D Y

    2008-01-01

    We demonstrate the first operation of CdZnTe room-temperature detectors in a liquid scintillator environment. This work follows conceptually the Heusser-type detector method of operating HPGe detectors in liquid nitrogen and liquid argon but instead for a far more practical room-temperature ensemble with the aim of achieving ultra-low background levels for radiation detection.

  6. Analysis of verbal communication during teaching in the operating room and the potentials for surgical training.

    Science.gov (United States)

    Blom, E M; Verdaasdonk, E G G; Stassen, L P S; Stassen, H G; Wieringa, P A; Dankelman, J

    2007-09-01

    Verbal communication in the operating room during surgical procedures affects team performance, reflects individual skills, and is related to the complexity of the operation process. During the procedural training of surgeons (residents), feedback and guidance is given through verbal communication. A classification method based on structural analysis of the contents was developed to analyze verbal communication. This study aimed to evaluate whether a classification method for the contents of verbal communication in the operating room could provide insight into the teaching processes. Eight laparoscopic cholecystectomies were videotaped. Two entire cholecystectomies and the dissection phase of six additional procedures were analyzed by categorization of the communication in terms of type (4 categories: commanding, explaining, questioning, and miscellaneous) and content (9 categories: operation method, location, direction, instrument handling, visualization, anatomy and pathology, general, private, undefinable). The operation was divided into six phases: start, dissection, clipping, separating, control, closing. Classification of the communication during two entire procedures showed that each phase of the operation was dominated by different kinds of communication. A high percentage of explaining anatomy and pathology was found throughout the whole procedure except for the control and closing phases. In the dissection phases, 60% of verbal communication concerned explaining. These explaining communication events were divided as follows: 27% operation method, 19% anatomy and pathology, 25% location (positioning of the instrument-tissue interaction), 15% direction (direction of tissue manipulation), 11% instrument handling, and 3% other nonclassified instructions. The proposed classification method is feasible for analyzing verbal communication during surgical procedures. Communication content objectively reflects the interaction between surgeon and resident. This

  7. 49 CFR 195.446 - Control room management.

    Science.gov (United States)

    2010-10-01

    ... system must have a written alarm management plan to provide for effective controller response to alarms...; (iv) Procedures; (v) SCADA system configuration; and (vi) SCADA system performance. (2) Include... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 195.446 Section 195.446...

  8. Ge-on-Si laser operating at room temperature.

    Science.gov (United States)

    Liu, Jifeng; Sun, Xiaochen; Camacho-Aguilera, Rodolfo; Kimerling, Lionel C; Michel, Jurgen

    2010-03-01

    Monolithic lasers on Si are ideal for high-volume and large-scale electronic-photonic integration. Ge is an interesting candidate owing to its pseudodirect gap properties and compatibility with Si complementary metal oxide semiconductor technology. Recently we have demonstrated room-temperature photoluminescence, electroluminescence, and optical gain from the direct gap transition of band-engineered Ge-on-Si using tensile strain and n-type doping. Here we report what we believe to be the first experimental observation of lasing from the direct gap transition of Ge-on-Si at room temperature using an edge-emitting waveguide device. The emission exhibited a gain spectrum of 1590-1610 nm, line narrowing and polarization evolution from a mixed TE/TM to predominantly TE with increasing gain, and a clear threshold behavior.

  9. Semiconductor terahertz technology devices and systems at room temperature operation

    CERN Document Server

    Carpintero, G; Hartnagel, H; Preu, S; Raisanen, A

    2015-01-01

    Key advances in Semiconductor Terahertz (THz) Technology now promises important new applications enabling scientists and engineers to overcome the challenges of accessing the so-called "terahertz gap".  This pioneering reference explains the fundamental methods and surveys innovative techniques in the generation, detection and processing of THz waves with solid-state devices, as well as illustrating their potential applications in security and telecommunications, among other fields. With contributions from leading experts, Semiconductor Terahertz Technology: Devices and Systems at Room Tempe

  10. EARLY-STAGE DESIGN AND EVALUATION FOR NUCLEAR POWER PLANT CONTROL ROOM UPGRADES

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring; Jeffrey C. Joe; Thomas A. Ulrich; Roger T. Lew

    2015-03-01

    As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate operator performance with these systems as part of a verification and validation process. While there is regulatory and industry guidance for some modernization activities, there are no well defined standard processes or predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages. This paper proposes a framework defining the design process and metrics for evaluating human system interfaces as part of control room modernization. The process and metrics are generalizable to other applications and serve as a guiding template for utilities undertaking their own control room modernization activities.

  11. Optimization of recirculating laminar air flow in operating room air conditioning systems

    Directory of Open Access Journals (Sweden)

    Enver Yalcin

    2016-04-01

    Full Text Available The laminar flow air-conditioning system with 100% fresh air is used in almost all operating rooms without discrimination in Turkey. The laminar flow device which is working with 100% fresh air should be absolutely used in Type 1A operating rooms. However, there is not mandatory to use of 100% fresh air for Type 1B defined as places performed simpler operation. Compared with recirculating laminar flow, energy needs of the laminar flow with 100 % fresh air has been emerged about 40% more than re-circulated air flow. Therefore, when a recirculating laminar flow device is operated instead of laminar flow system with 100% fresh air in the Type 1B operating room, annual energy consumption will be reduced. In this study, in an operating room with recirculating laminar flow, optimal conditions have been investigated in order to obtain laminar flow form by analyzing velocity distributions at various supply velocities by using computational fluid dynamics method (CFD.

  12. Team of the Technical Control Room, TCR, at work

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    0202037_06 transmit of the instruction from a team TCR to the changing .0202037_01 Kenneth Olesen brings a solution to a user of the CERN, while Mark Harvey checks its monitors .0202037_02 Laurent Randot and Eric Lienard (with the phone) work in the control room .0202037_08 Mr Jean-Pierre Hernández, shift leader TCR , stay near the order console for the electric wire of the CERN .0202037_09 The order console with all the diode on .0202037_10 View of the control room .

  13. Bridging the gap: adapting advanced display technologies for use in hybrid control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Jokstad, Håkon [Inst. for Energy Technology, Halden (Norway); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-02-01

    The Institute for Energy Technology (IFE), runs the OECD Halden Reactor Project (HRP), featuring a state-of-the-art research simulator facility in Halden, Norway, called HAMMLAB. HAMMLAB serves two main purposes: the study of human behaviour in interaction with complex process systems; and the development, test and evaluation of prototype control centres and their individual systems. By studying operator performance in HAMMLAB and integrating the knowledge gained into new designs, the HRP contributes to improving operational safety, reliability, efficiency and productivity. The U.S. Department of Energy’s (DOE) Light Water Reactor Sustainability (LWRS) Program has contracted IFE to assist DOE national laboratory staff at Idaho National Laboratory (INL) in adapting HAMMLAB design concepts for the purpose of control room modernization at nuclear power plants in the U.S. In support of this effort, the DOE has built a simulator research facility at INL called the Human Systems Simulation Laboratory (HSSL). The HSSL is centered on control room modernization, in which industry provided plant instrumentation and controls are modified for upgrade opportunities. The HSSL houses the LWRS simulator, which is a reconfigurable full-scale and full-scope control room simulator. Consisting of 45 large touchscreens on 15 panels, the LWRS simulator is currently using this glass top technology to digitally represent and replicate the functionality of the analog I&C systems in existing control rooms. The LWRS simulator is reconfigurable in that different plant training simulator models obtained from the utilities can be run on the panels, and the panels can be physically moved and arranged to mimic the layout of those control rooms. The glass top technology and reconfigurability capabilities allow the LWRS simulator to be the research platform that is necessary to design, prototype, and validate human-system interface (HSI) technologies that can replace existing analog I&C. IFE has

  14. The operating room as a clinical learning environment: An exploratory study.

    Science.gov (United States)

    Meyer, Rhoda; Van Schalkwyk, Susan C; Prakaschandra, Rosaley

    2016-05-01

    Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite numerous studies that have been undertaken in this field, few have investigated the operating room as a clinical learning environment in the South African private healthcare context. The aim of this study was to determine nursing students' perceptions of the operating room as a clinical learning environment. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Eight nursing students completed an open-ended questionnaire, and twelve nursing students participated in the focus group discussion. Four themes emerged, namely, 'interpersonal factors', 'educational factors', 'private operating room context', and 'recommendations'. The opinion that the operating room offers an opportunity to gain skills unique to this context was expressed. However, despite the potential learning opportunities, the key findings of this study reveal negative perceptions of nursing students regarding learning experiences in the operating room. Exploration into the preparatory needs of students specific to learning outcomes before operating room placement should be considered. It will also be necessary to improve collaboration between lecturers, mentors and theatre managers.

  15. The effects of surgeons and anesthesiologists on operating room efficiency

    Directory of Open Access Journals (Sweden)

    Nessa Timoney

    2016-09-01

    Conclusion: In some procedures types a significant part of the variability in operative time is due to the interaction between the surgeon and anesthesiologist. Reviewing operative records should allow identification of efficient/inefficient combinations.

  16. Workflow in the operating room: review of Arrowhead 2004 seminar on imaging and informatics (Invited Paper)

    Science.gov (United States)

    Lemke, Heinz U.; Ratib, Osman M.; Horii, Steven C.

    2005-04-01

    This review paper is based on the 2004 UCLA Seminar on Imaging and Informatics (http://www.radnet.ucla.edu/Arrowhead2004/) which is a joint endeavour between the UCLA and the CARS organization, focussing on workflow analysis tools and the digital operating room. Eleven specific presentations of the Arrowhead Seminar have been summarized in this review referring to redesigning perioperative care for a high velocity OR, intraoperative ultrasound process and model, surgical workflow and surgical PACS, an integrated view , interactions in the surgical OR, workflow automation strategies and target applications, visualisation solutions for the operating room, navigating the fifth dimension, and design of digital operating rooms and interventional suites

  17. CMS Control Room during early morning collisions at 2.36 TeV.

    CERN Multimedia

    Richard Breedon (CMS)

    2009-01-01

    CMS recorded around 15000 collisions at 2.36 TeV with the whole detector operational, including the inner silicon systems (strips and pixels). A relatively quiet control room was still witness to excitement during the first online event displays of the collisions.

  18. MSFC Director James R. Thompson in Control Room

    Science.gov (United States)

    1988-01-01

    Marshall's fifth Center Director, James R. Thompson (1986-1989), in the control room of the Solid Rocket Booster (SRB)automated thermal protection system (TPS) removal facility. Under Dr. Thompson's leadership, the shuttle program was rekindled after the Challenger explosion. Return to Flight kept NASA 's future programs alive.

  19. Computer codes for evaluation of control room habitability (HABIT)

    Energy Technology Data Exchange (ETDEWEB)

    Stage, S.A. [Pacific Northwest Lab., Richland, WA (United States)

    1996-06-01

    This report describes the Computer Codes for Evaluation of Control Room Habitability (HABIT). HABIT is a package of computer codes designed to be used for the evaluation of control room habitability in the event of an accidental release of toxic chemicals or radioactive materials. Given information about the design of a nuclear power plant, a scenario for the release of toxic chemicals or radionuclides, and information about the air flows and protection systems of the control room, HABIT can be used to estimate the chemical exposure or radiological dose to control room personnel. HABIT is an integrated package of several programs that previously needed to be run separately and required considerable user intervention. This report discusses the theoretical basis and physical assumptions made by each of the modules in HABIT and gives detailed information about the data entry windows. Sample runs are given for each of the modules. A brief section of programming notes is included. A set of computer disks will accompany this report if the report is ordered from the Energy Science and Technology Software Center. The disks contain the files needed to run HABIT on a personal computer running DOS. Source codes for the various HABIT routines are on the disks. Also included are input and output files for three demonstration runs.

  20. Inside the LEP control room at start-up

    CERN Multimedia

    1989-01-01

    Physicists grouped around a screen in the LEP control room at the strat-up of LEP on 14 July 1989. The emotion of the moment is clear. Carlo Rubbia, Director-General of CERN at the time, is in the centre and on his left, Herwig Schopper, former Director-General of the Organization.

  1. Ergonomic design in the operating room: information technologies

    Science.gov (United States)

    Morita, Mark M.; Ratib, Osman

    2005-04-01

    The ergonomic design in the Surgical OR of information technology systems has been and continues to be a large problem. Numerous disparate information systems with unique hardware and display configurations create an environment similar to the chaotic environments of air traffic control. Patient information systems tend to show all available statistics making it difficult to isolate the key, relevant vitals for the patient. Interactions in this sterile environment are still being done with the traditional keyboard and mouse designed for cubicle office workflows. This presentation will address the shortcomings of the current design paradigm in the Surgical OR that relate to Information Technology systems. It will offer a perspective that addresses the ergonomic deficiencies and predicts how future technological innovations will integrate into this vision. Part of this vision includes a Surgical OR PACS prototype, developed by GE Healthcare Technologies, that addresses ergonomic challenges of PACS in the OR that include lack of portability, sterile field integrity, and UI targeted for diagnostic radiologists. GWindows (gesture control) developed by Microsoft Research and Voice command will allow for the surgeons to navigate and review diagnostic imagery without using the conventional keyboard and mouse that disrupt the integrity of the sterile field. This prototype also demonstrates how a wireless, battery powered, self contained mobile PACS workstation can be optimally positioned for a surgeon to reference images during an intervention as opposed to the current pre-operative review. Lessons learned from the creation of the Surgical OR PACS Prototype have demonstrated that PACS alone is not the end all solution in the OR. Integration of other disparate information systems and presentation of this information in simple, easy to navigate information packets will enable smoother interactions for the surgeons and other healthcare professionals in the OR. More intuitive

  2. Benefits of Advanced Control Room Technologies: Phase One Upgrades to the HSSL, Research Plan, and Performance Measures

    Energy Technology Data Exchange (ETDEWEB)

    Le Blanc, Katya [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rice, Brandon [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ulrich, Thomas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-05-01

    Control Room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. A full-scale modernization might, for example, entail replacement of all analog panels with digital workstations. Such modernizations have been undertaken successfully in upgrades in Europe and Asia, but the U.S. has yet to undertake a control room upgrade of this magnitude. Instead, nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digital modernizations. Previous research under the U.S. Department of Energy’s Light Water Reactor Sustainability Program has helped establish a systematic process for control room upgrades that support the transition to a hybrid control room. While the guidance developed to date helps streamline the process of modernization and reduce costs and uncertainty associated with introducing digital control technologies into an existing control room, these upgrades do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The aim of the control room benefits research is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report describes the initial upgrades to the HSSL and outlines the methodology for a pilot test of the HSSL configuration.

  3. Psychological and Physical Stress in Surgeons Operating in a Standard or Modern Operating Room

    DEFF Research Database (Denmark)

    Klein, M.; Andersen, L.P.H.; Alamili, M.

    2010-01-01

    concerning physical and psychological wellbeing before and after surgery and had their heart rate variability registered during surgery. Results: Preoperative to postoperative physical strain and pain measurements revealed a systematical difference with 14 of 15 parameters favoring the modern OR. Two...... of these parameters reached statistical significance. We did not find any significant differences in the subjective parameters of surgeon satisfaction or the measured heart rate variability parameters. Conclusions: Physical strain on the surgeon was reduced when performing laparoscopic cholecystectomy in a modern......Purpose: There have been no studies examining the effect of optimized ergonomic and technical environment on the psychological and physiological stress of the surgeon. The aim of this study was to examine whether optimized ergonomics and technical aids within a modern operating room (OR) affect...

  4. Allocation of surgeries to operating rooms by goal programing.

    Science.gov (United States)

    Ozkarahan, I

    2000-12-01

    High usage rate in a surgical suite is extremely important in meeting the increasing demand for health care services and reducing costs to improve quality of care. In this paper a goal programming model which can produce schedules that best serve the needs of the hospital, i.e., by minimizing idle time and overtime, and increasing satisfaction of surgeons, patients, and staff, is described. The approach involves sorting the requests for a particular day on the basis of block restrictions, room utilization, surgeon preferences and intensive care capabilities. The model is tested using the data obtained during field studies at Dokuz Eylul University Hospital. The model is also tested for alternative achievement functions to examine the model's ability to satisfy abstract goals.

  5. Operating room metrics score card-creating a prototype for individualized feedback.

    Science.gov (United States)

    Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

    2014-11-01

    The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers.

  6. Controlling allergens in animal rooms by using curtains

    DEFF Research Database (Denmark)

    Krohn, Thomas Cæcius; Itter, Gabi; Fosse, Richard

    2006-01-01

    . The experimental situation we studied provides some information regarding allergen disposition in animal rooms but is clearly artificial and does not reflect a typical, ‘real-world’ environment in terms of preventing exposure of workers to allergens. Plastic curtains with holes were placed in front of racks......The reduction and control of allergens in the animal facility is important for staff working with laboratory animals. This study was designed to evaluate the efficiency of perforated Makrolon curtains in front of racks as a method to reduce the amount of allergen in the animal room...... the curtains and prevents its spread from the cages into the aisle. The present study shows that the use of curtains in front of the cage racks is an efficient way to prevent spread of allergens from rodent cages to the entire animal room....

  7. Predicting Correct Body Posture based on Theory of Planned Behavior in Iranian Operating Room Nurses

    National Research Council Canada - National Science Library

    BAHAREH ABEDI; RABIOLLAH FARMANBAR1; SAEED OMIDI; MAHDI JAHANGIR BLOURCHIAN

    2015-01-01

    Due to the importance of correct posture for preventing musculoskeletal disorders, the purpose of this study was to evaluate Theory of Planned Behavior in Predicting correct Body Posture in operating room...

  8. Mean sound level in operation rooms in a referral hospital: a brief report

    Directory of Open Access Journals (Sweden)

    Ahmad Joneidi Jafari

    2014-02-01

    Conclusion: Overall total noise dose during all types of surgeries was measured as twice of permitted dose and also orthopedic and general operation rooms experience brief periods of noise exposure in excess.

  9. Science Support Room Operations During Desert RATS 2009

    Science.gov (United States)

    Lofgren, G. E.; Horz, F.; Bell, M. S.; Cohen, B. A.; Eppler,D. B.; Evans, C. a.; Hodges, K. V.; Hynek, B. M.; Gruener, J. E.; Kring, D. A.; hide

    2010-01-01

    NASA's Desert Research and Technology Studies (D-RATS) field test is a demonstration that combines operations development, technology advances and science in analog planetary surface conditions. The focus is testing preliminary operational concepts for extravehicular activity (EVA) systems by providing hands-on experience with simulated surface operations and EVA hardware and procedures. The DRATS activities also develop technical skills and experience for the engineers, scientists, technicians, and astronauts responsible for realizing the goals of the Lunar Surface Systems Program. The 2009 test is the twelfth for the D-RATS team.

  10. Look into the PS Main Control Room (partial view)

    CERN Multimedia

    1974-01-01

    Jean-Pierre Potier at work. The 26 GeV Synchrotron and later also its related machines (Linacs 1,2,3; PS-Booster, LEP-Injector Linacs and Electron-Positron Accumulator; Antiproton Accumulator, Antiproton Collector, Low Energy Antiproton Ring and more recently Antiproton Decelerator) were all controlled from the PS control room situated at the Meyrin site. The SPS and LEP were controlled from a separat control centre on the Prevessin site. In 2005 all controls were transferred to the Prevessin centre.

  11. Baseline Evaluations to Support Control Room Modernization at Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Boring, Ronald L.; Joe, Jeffrey C.

    2015-02-01

    For any major control room modernization activity at a commercial nuclear power plant (NPP) in the U.S., a utility should carefully follow the four phases prescribed by the U.S. Nuclear Regulatory Commission in NUREG-0711, Human Factors Engineering Program Review Model. These four phases include Planning and Analysis, Design, Verification and Validation, and Implementation and Operation. While NUREG-0711 is a useful guideline, it is written primarily from the perspective of regulatory review, and it therefore does not provide a nuanced account of many of the steps the utility might undertake as part of control room modernization. The guideline is largely summative—intended to catalog final products—rather than formative—intended to guide the overall modernization process. In this paper, we highlight two crucial formative sub-elements of the Planning and Analysis phase specific to control room modernization that are not covered in NUREG-0711. These two sub-elements are the usability and ergonomics baseline evaluations. A baseline evaluation entails evaluating the system as-built and currently in use. The usability baseline evaluation provides key insights into operator performance using the control system currently in place. The ergonomics baseline evaluation identifies possible deficiencies in the physical configuration of the control system. Both baseline evaluations feed into the design of the replacement system and subsequent summative benchmarking activities that help ensure that control room modernization represents a successful evolution of the control system.

  12. Hand washing in operating room: a procedural comparison

    Directory of Open Access Journals (Sweden)

    Alessia Stilo

    2016-09-01

    Full Text Available BACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce microbial contamination of  surgical wound in case of non detected break of the gloves. The aim of our study is to evaluate the efficacy three antiseptics: Povi-iodine scrub; EPG (Ethanol, Hydrogen Peroxide, Glycerol, recommended by WHO, and common marseille soap type in a liquid formulation. METHODS It was designed a randomized, double-blind, single-center study conducted in the University Hospital of Messina, from January to June 2013. We asked operators to put the fingertips of their right hand (if not left-handed for one minute on the PCA medium, before washing with the three types of antiseptics, and after washing and drying. Drying was made using sterile gauzes or disposable wipes. Then, we measured the number of colony forming units per mL (CFU/mL and calculated the percentage of microbial load reduction. RESULTS 211 samples have been considered for statistical analysis: in 42 samples, in fact, initial microbial load was lower than after washing. Washing with EPG reduced CFU/ml from  a mean of 38,9 to 4,1 (86,5% reduction, washing with povi-iodine scrub from 59,55 to 12,9 (75,9% reduction and washing with Marseille soap from 47,26 to 12,7 (64,3% reduction. CONCLUSIONS Our study shows that washing with EPG has superior efficacy in CFU reduction. Antiseptic hand washing, however, cannot be considered the only measure to reduce infections: the anomaly of some results (initial microbial load lower than after washing  demonstrates that drying is an essential phase in the presurgical preparation. Therefore, hand hygiene must be part of a more complex strategy of surveillance and control of nosocomial infections

  13. Control of Computer Room Air Conditioning using IT Equipment Sensors

    Energy Technology Data Exchange (ETDEWEB)

    Bell, Geoffrey C.; Storey, Bill; Patterson, Michael K.

    2009-09-30

    The goal of this demonstration was to show how sensors in IT equipment could be accessed and used to directly control computer room air conditioning. The data provided from the sensors is available on the IT network and the challenge for this project was to connect this information to the computer room air handler's control system. A control strategy was developed to enable separate control of the chilled water flow and the fans in the computer room air handlers. By using these existing sensors in the IT equipment, an additional control system is eliminated (or could be redundant) and optimal cooling can be provided saving significant energy. Using onboard server temperature sensors will yield significant energy reductions in data centers. Intel hosted the demonstration in its Santa Clara, CA data center. Intel collaborated with IBM, HP, Emerson, Wunderlich-Malec Engineers, FieldServer Technologies, and LBNL to install the necessary components and develop the new control scheme. LBNL also validated the results of the demonstration.

  14. Multidisciplinary teamwork improves use of the operating room: a multicenter study.

    Science.gov (United States)

    van Veen-Berkx, Elizabeth; Bitter, Justin; Kazemier, Geert; Scheffer, Gert J; Gooszen, Hein G

    2015-06-01

    Poor inter-professional collaboration might negatively influence adequate planning of operative procedures. Interventions capable of improving inter-professional collaboration will positively impact professional practice and health care outcomes. Radboud University Medical Center (UMC) redesigned their operating room (OR) scheduling method by implementing cross-functional teams (CFTs). In this center, positive effects of CFTs were already demonstrated in a mono-center study. This study aims to confirm these effects by comparing the Radboud data with data from 6 other similar centers using a nationwide OR benchmark collaborative. The effect of CFTs was measured by the performance indicator "raw utilization." The Kruskal-Wallis one-way ANOVA was applied to compare OR performance among all 7 centers. The Wilcoxon-Mann-Whitney test was used to determine differences in OR performance between Radboud UMC and the control group. Operating room performance differed significantly among all 7 centers (p<0.0005). Radboud UMC demonstrated the highest median raw utilization of 94% vs 85% in the control group (p<0.0005). Box-and-whisker plots validated the reduced variation during the years, indicating an organizational learning effect. Therefore, not only a better performance than the control group, but also a gradual improvement of this performance during the years. This study shows that multidisciplinary collaboration in CFTs during the perioperative phase has a positive influence on OR scheduling and use of OR time. Other national databases considering mortality rates also support the idea that introducing CFTs is not only an important condition for improving OR performance, but also for improving quality of care. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. [Interface interconnection and data integration in implementing of digital operating room].

    Science.gov (United States)

    Feng, Jingyi; Chen, Hua; Liu, Jiquan

    2011-10-01

    The digital operating-room, with highly integrated clinical information, is very important for rescuing lives of patients and improving quality of operations. Since equipments in domestic operating-rooms have diversified interface and nonstandard communication protocols, designing and implementing an integrated data sharing program for different kinds of diagnosing, monitoring, and treatment equipments become a key point in construction of digital operating room. This paper addresses interface interconnection and data integration for commonly used clinical equipments from aspects of hardware interface, interface connection and communication protocol, and offers a solution for interconnection and integration of clinical equipments in heterogeneous environment. Based on the solution, a case of an optimal digital operating-room is presented in this paper. Comparing with the international solution for digital operating-room, the solution proposed in this paper is more economical and effective. And finally, this paper provides a proposal for the platform construction of digital perating-room as well as a viewpoint for standardization of domestic clinical equipments.

  16. Rule-based medical device adaptation for the digital operating room.

    Science.gov (United States)

    Franke, Stefan; Neumuth, Thomas

    2015-08-01

    A workflow-driven cooperative operating room needs to be established in order to successfully unburden the surgeon and the operating room staff very time-consuming information-seeking and configuration tasks. We propose an approach towards the integration of intraoperative surgical workflow management and integration technologies. The concept of rule-based behavior is adapted to situation-aware medical devices. A prototype was implemented and experiments with sixty recorded brain tumor removal procedures were conducted to test the proposed approach. An analysis of the recordings indicated numerous applications, such as automatic display configuration, room light adaptation and pre-configuration of medical devices and systems.

  17. Operational experience with room temperature continuous wave accelerator structures

    Science.gov (United States)

    Alimov, A. S.; Ishkhanov, B. S.; Piskarev, I. M.; Shvedunov, V. I.; Tiunov, A. V.

    1993-05-01

    The paper reports the results of the computer simulation of parameters of the on-axis coupled accelerator structure for the continuous wave racetrack microtron. The operational experience with the accelerating sections on the basis of the on-axis coupled structure is described.

  18. CERN opens up its control rooms to youngsters

    CERN Multimedia

    CERN Bulletin

    2011-01-01

    CERN is inviting 13 to 18 year-olds to come and spend a couple of hours in the control rooms of the LHC and its experiments. Registration is now open.   Is your neighbour's kid eager to come and see what's going on in the CERN control rooms for himself? Is your niece from Germany fascinated by the famous accelerator near Geneva that she's heard about and asking to know more? Then Researchers Night is for them! From 6.00 p.m. on Friday 23 September until 1.00 a.m. the following morning, the LHC and its experiments will open their doors to 13 to 18 year-olds. They are invited to come and spend a couple of hours in the control rooms watching the physicists and taking part in various activities. ALICE, ATLAS, CMS, LHCb, TOTEM, and the CERN Control Centre (CCC) will all be welcoming visitors. For this second year of CERN's involvement in European Researchers Night, the CERN exhibitions will be open late and special activities will be organised in Microcosm....

  19. BEYOND INTEGRATED SYSTEM VALIDATION: USE OF A CONTROL ROOM TRAINING SIMULATOR FOR PROOF-OF-CONCEPT INTERFACE DEVELOPMENT

    Energy Technology Data Exchange (ETDEWEB)

    Ronald Boring; Vivek Agarwal

    2012-07-01

    This paper provides background on a reconfigurable control room simulator for nuclear power plants. The main control rooms in current nuclear power plants feature analog technology that is growing obsolete. The need to upgrade control rooms serves the practical need of maintainability as well as the opportunity to implement newer digital technologies with added functionality. There currently exists no dedicated research simulator for use in human factors design and evaluation activities for nuclear power plants in the US. The new research simulator discussed in this paper provides a test bed in which operator performance on new control room concepts can be benchmarked against existing control rooms and in which new technologies can be validated for safety and usability prior to deployment.

  20. Human Factors Engineering Aspects of Modifications in Control Room Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Hugo, Jacques; Clefton, Gordon; Joe, Jeffrey

    2017-06-01

    This report describes the basic aspects of control room modernization projects in the U.S. nuclear industry and the need for supplementary guidance on the integration of human factors considerations into the licensing and regulatory aspects of digital upgrades. The report pays specific attention to the integration of principles described in NUREG-0711 (Human Factors Engineering Program Review Model) and how supplementary guidance can help to raise general awareness in the industry regarding the complexities of control room modernization projects created by many interdependent regulations, standards and guidelines. The report also describes how human factors engineering principles and methods provided by various resources and international standards can help in navigating through the process of licensing digital upgrades. In particular, the integration of human factors engineering guidance and requirements into the process of licensing digital upgrades can help reduce uncertainty related to development of technical bases for digital upgrades that will avoid the introduction of new failure modes.

  1. Malfunction analysis response system (MARS) for nuclear power plants control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Peters, F.; Rossmann, D.L.

    1984-01-01

    Whenever the need for the safe and reliable operation of a complex system exists, a major requirement for success is the actions of the people involved. This is especially true when a time-critical response is required. In this context, the operation of a nuclear power plant is exemplary. Lessons from the Three Mile Island-2 incident show that insufficient attention was paid to the man/machine interface. Since that time, considerable effort has been directed by the nuclear industry toward the improvement of control room instrumentation, emergency operating procedures, and operator training. The improvement of the safety of nuclear power plants through the reduction of operator errors is discussed. The nuclear power plant operator's diagnostic role is analogous to that of a flight controller for a manned space flight mission. Both must be able to quickly understand and integrate large quantities of information on current system operation with background data on system design and performance.

  2. Risk Factors for Return to the Operating Room after Resident-Performed Cataract Surgery.

    Science.gov (United States)

    Menda, Shivali A; Driver, Todd H; Neiman, Alexandra E; Blumberg, Seth; Naseri, Ayman; Stewart, Jay M

    2016-09-29

    Investigate risk factors for unplanned return to the operating room after resident-performed cataract surgery. Retrospective case-control study. Institutional. Study population: All patients with reoperation within 90 days of resident-performed phacoemulsification were matched to four control eyes which had surgery within 30 days of the reoperation at the same institution. Billing codes were used to identify all patients who underwent resident-performed intended phacoemulsification with intraocular lens placement from January 2005 to December 2010. Investigated risk factors for reoperation included cataract characteristics and preexisting ocular co-morbidities, including diabetic retinopathy, retinal detachment history, glaucoma, corneal pathology, and uveitis. Additional preoperative risk factors studied included resident training year, history of tamsulosin use, phacodonesis, pupillary dilation, presence of pseudoexfoliation, myopia, history of trauma, visual acuity, and monocular status. Intraoperative variables were the use of iris expansion devices, use of capsular stain, attending type, incision type, use of sutures, vitreous loss, anesthesia type, and phacoemulsification technique. There were 67 returns to the operating room (i.e., cases) over five years that were assigned to 268 control eyes. In preoperative multivariate analysis, phacoemulsification done by a first- or second-year resident (OR 3.2, 95% CI: 1.7-6.0, p risk of reoperation. In postoperative multivariate analysis, only the use of the divide-and-conquer technique (OR 4.0, 95% CI:1.7-9.2, p = 0.001) was associated with an increased risk of reoperation. Phacoemulsification done by a junior resident or using the divide-and-conquer technique had the highest risk of reoperation.

  3. Operating room fire prevention: creating an electrosurgical unit fire safety device.

    Science.gov (United States)

    Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J

    2014-08-01

    To reduce the incidence of surgical fires. Operating room fires represent a potentially life-threatening hazard and are triggered by the electrosurgical unit (ESU) pencil. Carbon dioxide is a fire suppressant and is a routinely used medical gas. We hypothesize that a shroud of protective carbon dioxide covering the tip of the ESU pencil displaces oxygen, thereby preventing fire ignition. Using 3-dimensional modeling techniques, a polymer sleeve was created and attached to an ESU pencil. This sleeve was connected to a carbon dioxide source and directed the gas through multiple precisely angled ports, generating a cone of fire-suppressive carbon dioxide surrounding the active pencil tip. This device was evaluated in a flammability test chamber containing 21%, 50%, and 100% oxygen with sustained ESU activation. The sleeve was tested with and without carbon dioxide (control) until a fuel was ignited or 30 seconds elapsed. Time to ignition was measured by high-speed videography. Fires were ignited with each control trial (15/15 trials). The control group median ± SD ignition time in 21% oxygen was 3.0 ± 2.4 seconds, in 50% oxygen was 0.1 ± 1.8 seconds, and in 100% oxygen was 0.03 ± 0.1 seconds. No fire was observed when the fire safety device was used in all concentrations of oxygen (0/15 trials; P fire ignition was 76% to 100%. A sleeve creating a cone of protective carbon dioxide gas enshrouding the sparks from an ESU pencil effectively prevents fire in a high-flammability model. Clinical application of this device may reduce the incidence of operating room fires.

  4. First-of-A-Kind Control Room Modernization Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-02-01

    This project plan describes a comprehensive approach to the design of an end-state concept for a modernized control room for Palo Verde. It describes the collaboration arrangement between the DOE LWRS Program Control Room Modernization Project and the APS Palo Verde Nuclear Generating Station. It further describes the role of other collaborators, including the Institute for Energy Technology (IFE) and the Electric Power Research Institute (EPRI). It combines advanced tools, methodologies, and facilities to enable a science-based approach to the validation of applicable engineering and human factors principles for nuclear plant control rooms. It addresses the required project results and documentation to demonstrate compliance with regulatory requirements. It describes the project tasks that will be conducted in the project, and the deliverable reports that will be developed through these tasks. This project plan will be updated as new tasks are added and as project milestones are completed. It will serve as an ongoing description on the project both for project participants and for industry stakeholders.

  5. Human factor engineering based design and modernization of control rooms with new I and C systems

    Energy Technology Data Exchange (ETDEWEB)

    Larraz, J.; Rejas, L. [New Control Room Design Dept., Av. Montes de Oca, 1, 28703 San Sebastian de los Reyes-Madrid (Spain); Ortega, F. [Control Room and Simulation Dept., Av. Montes de Oca, 1, 28703 San Sebastian de los Reyes-Madrid (Spain)

    2012-07-01

    Instrumentation and Control (I and C) systems of the latest nuclear power plants are based on the use of digital technology, distributed control systems and the integration of information in data networks (Distributed Control and Instrumentation Systems). This has a repercussion on Control Rooms (CRs), where the operations and monitoring interfaces correspond to these systems. These technologies are also used in modernizing I and C systems in currently operative nuclear power plants. The new interfaces provide additional capabilities for operation and supervision, as well as a high degree of flexibility, versatility and reliability. An example of this is the implementation of solutions such as compact stations, high level supervision screens, overview displays, computerized procedures, new operational support systems or intelligent alarms processing systems in the modernized Man-Machine Interface (MMI). These changes in the MMI are accompanied by newly added Software (SW) controls and new solutions in automation. Tecnatom has been leading various projects in this area for several years, both in Asian countries and in the United States, using in all cases international standards from which Tecnatom own methodologies have been developed and optimized. The experience acquired in applying this methodology to the design of new control rooms is to a large extent applicable also to the modernization of current control rooms. An adequate design of the interface between the operator and the systems will facilitate safe operation, contribute to the prompt identification of problems and help in the distribution of tasks and communications between the different members of the operating shift. Based on Tecnatom experience in the field, this article presents the methodological approach used as well as the most relevant aspects of this kind of project. (authors)

  6. Migration of Older to New Digital Control Systems in Nuclear Power Plant Main Control Rooms

    Energy Technology Data Exchange (ETDEWEB)

    Kovesdi, Casey Robert [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey Clark [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-04-01

    The United States (U.S.) Department of Energy (DOE) Office of Nuclear Energy (NE) has the primary mission to advance nuclear power by resolving socio-technical issues through research and development (R&D). One DOE-NE activity supporting this mission is the Light Water Reactor Sustainability (LWRS) program. LWRS has the overall objective to sustain the operation of existing commercial nuclear power plants (NPPs) through conducting R&D across multiple “pathways,” or R&D focus areas. The Advanced Instrumentation, Information, and Control (II&C) Systems Technologies pathway conducts targeted R&D to address aging and reliability concerns with the legacy instrumentation and control (I&C) and related information systems in operating U.S. NPPs. This work involves (1) ensuring that legacy analog II&C systems are not life-limiting issues for the LWR fleet, and (2) implementing digital II&C technology in a manner that enables broad innovation and business improvement in the NPP operating model. Under the LWRS Advanced II&C pathway, Human Factors experts at Idaho National Laboratory (INL) have been conducting R&D in support of NPP main control room (MCR) modernization activities. Work in prior years has focused on migrating analog I&C systems to new digital I&C systems (). In fiscal year 2016 (FY16), one new focus area for this research is migrating older digital I&C systems to new and advanced digital I&C systems. This report summarizes a plan for conducting a digital-to-digital migration of a legacy digital I&C system to a new digital I&C system in support of control room modernization activities.

  7. Requirements for future control room and visualization features in the Web-of-Cells framework defined in the ELECTRA project

    DEFF Research Database (Denmark)

    Tornelli, Carlo; Zuelli, Roberto; Marinelli, Mattia

    2017-01-01

    This paper outlines an overview of the general requirements for the control rooms of the future power systems (2030+). The roles and activities in the future control centres will evolve with respect to the switching, dispatching and restoration functions currently active. The control centre...... operators will supervise on the power system and intervene - when necessary - thanks to the maturation and wide scale deployment of flexible controls. For the identification of control room requirements, general trends in power system evolution are considered and mainly the outcomes of the ELECTRA IRP...... project, that proposes a new Web-of-Cell (WoC) power system control architecture. Dedicated visualization features are proposed, aimed to support the control room operators activities in a WoC oriented approach. Furthermore, the work takes into account the point of view of network operators about future...

  8. Conflicts in operating room: Focus on causes and resolution

    Directory of Open Access Journals (Sweden)

    Joginder Pal Attri

    2015-01-01

    Full Text Available The operation theater (OT environment is the most complex and volatile workplace where two coequal physicians share responsibility of one patient. Difference in information, opinion, values, experience and interests between a surgeon and anesthesiologist may arise while working in high-pressure environments like OT, which may trigger conflict. Quality of patient care depends on effective teamwork for which multidisciplinary communication is an essential part. Troubled relationships leads to conflicts and conflicts leads to stressful work environment which hinders the safe discharge of patient care. Unresolved conflicts can harm the relationship but when handled in a positive way it provides an opportunity for growth and ultimately strengthening the bond between two people. By learning the skills to resolve conflict, we can keep our professional relationship healthy and strong which is an important component of good patient care.

  9. Operating room use of hypertonic solutions: a clinical review

    Directory of Open Access Journals (Sweden)

    Gustavo Azoubel

    2008-01-01

    Full Text Available Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies.

  10. Virtual control room, the REMOT project, networking pilot studies

    NARCIS (Netherlands)

    Andree, H. M. A.; Habets, J.; Koopmans, M.; Kooijman, W.; Kemmerling, G.; Korten, M.; de Laat, C. T. A. M.; Lourens, W.; van der Meer, E. A.; Oomens, A. A. M.; Venema, J.

    1998-01-01

    The Remote Experiment Monitoring and Control (REMOT) project objective is to develop a system architecture to allow remote control of scientific experiments and facilities that require real time operation and multimedia information feedback, using available or deploying communications infrastructure

  11. Anthropometric Considerations in the Modernized Main Control Room: Application to a Virtual Nuclear Power Plant Control Panel

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Chih Wei; Cheng, Tsung Chieh [Institute of Nuclear Energy Research, Taoyuan (China); Lin, Chiuhsiang Joe [Chung-Yuan Christian University, Chung Li (China)

    2011-08-15

    This study investigates the anthropometric considerations in the main control room (MCR) application to a virtual nuclear power plant (NPP) control panel. Influences of working postures and physical demands on the operational performance are also discussed. Finally, the present research provides a case example to illustrate the influences of anthropometric considerations on the control panel design for MCR operators by applying virtual reality (VR) technology. The MCR design primarily evolved in different countries. The datasets available is usually insufficient or inconsistent for the end users. To solve the upper mentioned problem, this study put emphasis on applying VR technology to anthropometric considerations support control panel design in the modernized MCR. Although the concept of applying VR technology on anthropometric considerations in this paper is related to the MCR in NPPs, it could be easily applied for the purposes of any type of control room in a similar manner.

  12. [Intelligent operating room suite : From passive medical devices to the self-thinking cognitive surgical assistant].

    Science.gov (United States)

    Kenngott, H G; Wagner, M; Preukschas, A A; Müller-Stich, B P

    2016-12-01

    Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

  13. Advanced Technologies in Safe and Efficient Operating Rooms

    Science.gov (United States)

    2008-02-01

    Corp., San Jose, CA) with two external memory banks to serve as input and output image memory. The memory banks used were 1-GB DDR2 small-outline...implemented using VHDL and was built around the DDR2 DRAM controller megacore supplied with Altera Quartus II. Both filtering modules were custom designed...performed using Modelsim SE 6.2 (Mentor Graphics, San Jose, CA). For this purpose, DDR2 DRAM simulation models provided by Micron (http://www.micron.com

  14. Mobile devices in the operating room: Intended and unintended consequences for nurses' work.

    Science.gov (United States)

    Sergeeva, Anastasia; Aij, Kjeld; van den Hooff, Bart; Huysman, Marleen

    2016-12-01

    This article reports the results of a case study of the consequences of mobile device use for the work practices of operating room nurses. The study identifies different patterns of mobile technology use by operating room nurses, including both work-related and non-work-related use. These patterns have multiple consequences for nurses, such as improvements in information access, e-learning and work-related communication, as well as a perceived increase in distractions from the collaborative work. We conceptualize these consequences in terms of three level effects and explain how we find both positive and negative consequences on the third level. On the positive side, improvements were found in how nurses spent their unoccupied time during the stable parts of operations, contributing to their well-being and job satisfaction. A negative consequence was the perceived increase in distraction from the collaborative operating room work practices.

  15. Engineering of data base application to control room in operation plant; Reingemieria de la aplicacion de la base de datos del conexionado de los aparatos de los paneles de mando de la sala de control de una central en operacion

    Energy Technology Data Exchange (ETDEWEB)

    Vallier Pino, J.; Fernandez Garcia, N. C.; Tielas Reina, M.

    2004-07-01

    The large number of Setpoints and associated allowable values that have to be determined in a nuclear power plant prompted EMPRESARIOS AGRUPADOS to develop the AVACO program to computerise and optimise the calculation process. This application has been developed based on Microsoft Access 97 database and Mathsoft Mathcad 8 calculation program. The calculation methodology used by AVACO complies with the procedures and criteria established in Regulatory Guide 1.105, issue 3, dated December 1999, Setpoints for Safety-Related Instrumentation, and in standard ISA-S67.04.01-2000. The computerised calculation of nominal trip points and allowable values for trip functions saves time, prevents possible errors which are more likely to occur in manual calculation, and allows adequate control of input data and results. The database contains all input data and associated references required for calculation, as well as the calculation results. This integration enables the quick and efficient handling, storage and updating of large volumes of data required for calculation. Mathcad 8 performs the calculations using templates created for different measuring channel configurations. Said templates define in text form the formulae used. Following the manual introduction of input data into the database, these data are automatically transferred to the corresponding spreadsheet template; the calculation results are then automatically incorporated back into the database. EMPRESARIOS AGRUPADOS and TECNATOM are currently using this application the Calculation of Setpoints for the Lungmen Nuclear Power Plant project.

  16. Application of an Online Reference for Reviewing Basic Statistical Principles of Operating Room Management

    Science.gov (United States)

    Dexter, Franklin; Masursky, Danielle; Wachtel, Ruth E.; Nussmeier, Nancy A.

    2010-01-01

    Operating room (OR) management differs from clinical anesthesia in that statistical literacy is needed daily to make good decisions. Two of the authors teach a course in operations research for surgical services to anesthesiologists, anesthesia residents, OR nursing directors, hospital administration students, and analysts to provide them with the…

  17. PID Controller with Operational Amplifier

    Directory of Open Access Journals (Sweden)

    Cristian Paul Chioncel

    2009-01-01

    Full Text Available The paper presents a PID controller made with LM741 operational amplifier that implement the PID controllers laws and allow for a widerange of applications of in the field of automatic control of technicalprocesses and systems.

  18. Low frequency sound field control for loudspeakers in rectangular rooms using CABS (Controlled Acoustical Bass System)

    DEFF Research Database (Denmark)

    Nielsen, Sofus Birkedal; Celestinos, Adrian

    2010-01-01

    Rectangular rooms are the most common shape for sound reproduction, but at low frequencies the reflections from the boundaries of the room cause large spatial variations in the sound pressure level.  Variations up to 30 dB are normal, not only at the room modes, but basically at all frequencies....... As sound propagates in time, it seems natural that the problems can best be analyzed and solved in the time domain. A time based room correction system named CABS (Controlled Acoustical Bass System) has been developed for sound reproduction in rectangular listening rooms. It can control the sound...... distribution in the room at low frequencies by using multiple loudspeakers together with an optimal placement of the loudspeakers.  At low frequencies CABS will create a plane wave from the front wall loudspeakers which will be absorbed by additional loudspeakers at the rear wall giving an almost homogeneous...

  19. Elements of Clean-room Technology and Contamination Control

    Directory of Open Access Journals (Sweden)

    J.C. Kapoor

    2003-07-01

    Full Text Available The heart of the clean room is the high efticiency particualte air (HEPA/ultra-low penetration air (ULPA filter, which provides the highest level of air cleaning ever achieved by a singleprocess step. Filter technology has seen tremendous growth in terms of ultimate performance and air handling capacity. Mere installation of ULPA filters of 99.99995 per cent efficiency for 0.2 um aerosol is not sufficient for achieving the desired performance of a clean room. Other design aspects like flow fields, face velocity, number of air changes, make-up air fractions and precise control of other environmental parameters (temperature, humidity, airflow, noise, vibrations, electrostatic discharge, etc. are equally important.

  20. Simon van der Meer in the AA Control Room

    CERN Multimedia

    CERN PhotoLab

    1984-01-01

    Simon van der Meer, spiritus rector of the Antiproton Accumulator, in the AA Control Room. Inventor of stochastic cooling, on which the AA was based, and of the magnetic horn, with which the antiprotons were focused, he also wrote most of the software with which the AA was controlled, and spent uncountable numbers of hours in this chair to tickle the AA to top performance. 8 months after this picture was taken, he received, in October 1984, the Nobel prize, together with Carlo Rubbia, the moving force behind the whole Proton-Antiproton Collider project that led to the discovery, in 1983, of the W and Z intermediate bosons.

  1. In-office vs. operating room procedures for recurrent respiratory papillomatosis.

    Science.gov (United States)

    Miller, Anya J; Gardner, Glendon M

    2017-01-01

    We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13.5, and the mean interval between procedures was 14.3 months. An equal number of patients reported complications or adverse events with the two types of procedures-5 each. The difference in cost between the office procedure (mean: $3,413.00) and the operating room procedure (mean: $12,382.59) was almost $9,000, but these savings were offset by the fact that the office procedures needed to be performed three times as often. Patients reported slightly more anxiety and discomfort during the office procedures and, overall, they appeared to prefer the operating room procedure. We conclude that office procedures are significantly more cost-effective than operating room procedures, but their use may be limited by patient tolerance and the increased frequency of the procedure.

  2. Low frequency sound field control for loudspeakers in rectangular rooms using CABS (Controlled Acoustical Bass System)

    DEFF Research Database (Denmark)

    Nielsen, Sofus Birkedal; Celestinos, Adrian

    2010-01-01

    . As sound propagates in time, it seems natural that the problems can best be analyzed and solved in the time domain. A time based room correction system named CABS (Controlled Acoustical Bass System) has been developed for sound reproduction in rectangular listening rooms. It can control the sound...... distribution in the room at low frequencies by using multiple loudspeakers together with an optimal placement of the loudspeakers.  At low frequencies CABS will create a plane wave from the front wall loudspeakers which will be absorbed by additional loudspeakers at the rear wall giving an almost homogeneous...... sound field in the whole room, and short impulse response.  In a standard listening room (180 m3) only 4 loudspeakers are needed, 2 more than a traditional stereo setup. CABS is controlled by a developed DSP system. The time based approached might help with the understanding of sound field control...

  3. A Pilot Study Investigating the Effects of Advanced Nuclear Power Plant Control Room Technologies: Methods and Qualitative Results

    Energy Technology Data Exchange (ETDEWEB)

    BLanc, Katya Le [Idaho National Lab. (INL), Idaho Falls, ID (United States); Powers, David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey [Idaho National Lab. (INL), Idaho Falls, ID (United States); Spielman, Zachary [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rice, Brandon [Idaho National Lab. (INL), Idaho Falls, ID (United States); Fitzgerald, Kirk [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-08-01

    Control room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. Nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digital modernizations. Upgrades in the U.S. do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The goal of the control room upgrade benefits research is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report describes a pilot study to test upgrades to the Human Systems Simulation Laboratory at INL.

  4. OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC.

    Science.gov (United States)

    Rockstroh, M; Franke, S; Hofer, M; Will, A; Kasparick, M; Andersen, B; Neumuth, T

    2017-08-01

    Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed technologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders. The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners. The demonstration OR was qualitatively evaluated including technical as well as clinical aspects. In the evaluation, a questionnaire was used to obtain feedback from hospital operators. The clinical implications were covered by structured interviews with surgeons, anesthesiologists and OR staff. In the present work, we qualitatively evaluate a subset of the proposed concepts from the perspectives of various stakeholders. The feedback of the clinicians indicates that there is a need for a flexible data and control integration. The hospital operators stress the need for tools to simplify risk management in openly integrated operating rooms. The implementation of openly integrated operating rooms will positively affect the surgeons, the anesthesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evaluation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments.

  5. Review article: review of behavioral operations experimental studies of newsvendor problems for operating room management.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2010-06-01

    Operating room (OR) managers must plan staffing in the face of uncertain demand for OR time. Planning too much staffing results in underutilized OR time. Planning too little staffing causes overutilized time, which is approximately twice as expensive as underutilized time. Deciding how much staffing to plan for an OR is analogous to the classic newsvendor problem in operations research. A newsvendor must decide how much product to order based on its cost c and sales price p, plus estimates of the uncertain future demand for the product. The newsvendor problem has a simple mathematical solution. The correct amount of product to order is the (p - c)/p quantile of the demand for the product. This optimal order quantity is analogous mathematically to the number of hours of OR time for which staffing should be planned. We performed a systematic review of the behavioral operations experimental literature on newsvendor problems relevant to OR management. Student volunteers participating in experimental studies have great difficulty knowing how much product to order, given c, p, and the demand distribution. Decision making is only modestly improved by more frequent feedback. Even scores of rounds of ordering are insufficient for much learning to occur. Suboptimal decisions result from innate psychological biases. Students anchor on mean demand, make insufficient adjustments, and rely disproportionately on the most recent demand values. The behavior of OR managers who plan staffing for the OR is analogous to that of students participating in a newsvendor experiment. Month after month, an OR manager will plan too little staffing for the surgeon who consistently ends the day late and too much staffing for the surgeon who consistently does not fill an OR. Experimental studies of the newsvendor problem provide mechanistic insights into the reasons that OR managers make poor decisions when planning OR staffing. The students face no organizational factors or personality issues

  6. Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

    Science.gov (United States)

    Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

    2015-01-01

    To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Thermal cycling can extend tool life in orthopaedic operating rooms.

    Science.gov (United States)

    Katchky, Ryan N; McLachlin, Stewart D; Wong, Edwin K Y; Finkelstein, Joel; Kreder, Hans J; Whyne, Cari M

    2016-03-01

    Thermal cycling is a temperature modulation process developed to improve the performance, durability and longevity of materials. This process has been successfully utilized in the automotive, aeronautic and manufacturing industries. Surgical cutting tools undergo cyclical loading and generally fail by dulling, suggesting that thermal cycling may improve their performance and longevity. Ten 2.5 mm orthopaedic drill bits were randomized, with five undergoing thermal cycling within their sterile packaging and five serving as untreated controls. Using a servohydraulic testing machine, 100 drilling cycles were performed with each drill bit into the diaphyseal region of bovine femurs. After every 25 cycles, data was collected by performing identical drilling cycles into simulated human cortical bone material. Maximum force, maximum normalized torque and drilling work were measured, and a scanning electron microscope was used to measure outer corner wear. After 100 drilling cycles, the maximum drilling force, maximum normalized torque, drilling work and microscopic outer corner wear were all significantly lower for the treated drill bits (p cutting tools. Application of this technology may also be relevant to surgical cutting tools such as saw blades, burrs and reamers.

  8. [Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

    Science.gov (United States)

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital.

  9. The Association Between Operating Room Personnel and Turnover With Surgical Site Infection in More Than 12 000 Neurosurgical Cases.

    Science.gov (United States)

    Wathen, Connor; Kshettry, Varun R; Krishnaney, Ajit; Gordon, Steven M; Fraser, Thomas; Benzel, Edward C; Modic, Michael T; Butler, Sam; Machado, Andre G

    2016-12-01

    Surgical site infection (SSI) contributes significantly to postoperative morbidity and mortality and greatly increases the cost of care. To identify the impact of workflow and personnel-related risk factors contributing to the incidence of SSIs in a large sample of neurological surgeries. Data were obtained using an enterprisewide electronic health record system, operating room, and anesthesia records for neurological procedures conducted between January 1, 2009, and November 30, 2012. SSI data were obtained from prospective surveillance by infection preventionists using Centers for Disease Control and Prevention definitions. A multivariate model was constructed and refined using backward elimination logistic regression methods. The analysis included 12 528 procedures. Most cases were elective (94.5%), and the average procedure length was 4.8 hours. The average number of people present in the operating room at any time during the procedure was 10.0. The overall infection rate was 2.3%. Patient body mass index (odds ratio, 1.03; 95% confidence interval [CI], 1.01-1.04) and sex (odds ratio, 1.36; 95% CI, 1.07-1.72) as well as procedure length (odds ratio, 1.19 per additional hour; 95% CI, 1.15-1.23) and nursing staff turnovers (odds ratio, 1.095 per additional turnover; 95% CI, 1.02-1.21) were significantly correlated with the risk of SSI. This study found that patient body mass index and male sex were associated with an increased risk of SSI. Operating room personnel turnover, a modifiable, work flow-related factor, was an independent variable positively correlated with SSI. This study suggests that efforts to reduce operating room turnover may be effective in preventing SSI. OR, operating roomSSI, surgical site infection.

  10. [Unexpected atrial fibrillation when monitoring in operating room. Case of the trimester].

    Science.gov (United States)

    2014-05-01

    A real case reported to the SENSAR database of incidents is presented. In a patient scheduled for nose fracture repair surgery an unexpected atrial fibrillation was found when monitored in the operating room. The operation was not delayed. After induction of general anaesthesia heart rate suddenly increased and hemodinamic situation was impaired. Cardioversion was required. Two electric countershocks were given but sinus rhythm was not restored. Heart rate was controlled with amiodarone infusion. Optimal defibrillation characteristics are described in these cases. Increased risk of thromboembolism (1-2%) following cardioversion is present even if atrial thrombi are ruled out. The mainstay therapies of are rhythm and rate control and prevention of thromboembolic complications. We describe recommendations on the management of these critical situations with emphasis in learning through the creation of protocols and training practice in simulation. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  11. Factors related to teamwork performance and stress of operating room nurses.

    Science.gov (United States)

    Sonoda, Yukio; Onozuka, Daisuke; Hagihara, Akihito

    2017-07-25

    To evaluate operating room nurses' perception of teamwork performance and their level of mental stress and to identify related factors. Little is known about the factors affecting teamwork and the mental stress of surgical nurses, although the performance of the surgical team is essential for patient safety. The questionnaire survey for operation room nurses consisted of simple questions about teamwork performance and mental stress. Multivariate analyses were used to identify factors causing a sense of teamwork performance or mental stress. A large number of surgical nurses had a sense of teamwork performance, but 30-40% of operation room nurses were mentally stressed during surgery. Neither the patient nor the operation factors were related to the sense of teamwork performance in both types of nurses. Among scrub nurses, endoscopic and abdominal surgery, body mass index, blood loss and the American Society of Anesthesiologists physical status class were related to their mental stress. Conversely, circulating nurses were stressed about teamwork performance. The factors related to teamwork performance and mental stress during surgery differed between scrub and circulating nurses. Increased support for operation room nurses is necessary. The increased support leads to safer surgical procedures and better patient outcomes. © 2017 John Wiley & Sons Ltd.

  12. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.

    Science.gov (United States)

    Makary, Martin A; Sexton, J Bryan; Freischlag, Julie A; Holzmueller, Christine G; Millman, E Anne; Rowen, Lisa; Pronovost, Peter J

    2006-05-01

    Teamwork is an important component of patient safety. In fact, communication errors are the most common cause of sentinel events and wrong-site operations in the US. Although efforts to improve patient safety through improving teamwork are growing, there is no validated tool to scientifically measure teamwork in the surgical setting. Operating room personnel in 60 hospitals were surveyed using the Safety Attitudes Questionnaire. Surgeons, anesthesiologists, certified registered nurse anesthetists, and operating room nurses rated their own peers and each other using a 5-point Likert scale (1 = very low, 5 = very high). Overall response rate was 77.1% (2,135 of 2,769). Ratings of teamwork differed substantially by operating room caregiver type, with the greatest differences in ratings shown by physicians: surgeons (F[4, 2058] = 41.73, p teamwork exist in the operating room, with physicians rating the teamwork of others as good, but at the same time, nurses perceive teamwork as mediocre. Given the importance of communication and collaboration in patient safety, health care organizations should measure teamwork using a scientifically valid method. The Safety Attitudes Questionnaire can be used to measure teamwork, identify disconnects between or within disciplines, and evaluate interventions aimed at improving patient safety.

  13. Baseline Study Methodology for Future Phases of Research on Nuclear Power Plant Control Room Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Le Blanc, Katya Lee [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bower, Gordon Ross [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hill, Rachael Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States); Spielman, Zachary Alexander [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rice, Brandon Charles [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-07-01

    In order to provide a basis for industry adoption of advanced technologies, the Control Room Upgrades Benefits Research Project will investigate the benefits of including advanced technologies as part of control room modernization This report describes the background, methodology, and research plan for the first in a series of full-scale studies to test the effects of advanced technology in NPP control rooms. This study will test the effect of Advanced Overview Displays in the partner Utility’s control room simulator

  14. Active low frequency sound field control in a listening room using CABS (Controlled Acoustic Bass System) will also reduce the sound transmitted to neighbour rooms

    DEFF Research Database (Denmark)

    Nielsen, Sofus Birkedal; Celestinos, Adrian

    2012-01-01

    Sound in rooms and transmission of sound between rooms gives the biggest problems at low frequencies. Rooms with rectangular boundaries have strong resonance frequencies and will give big spatial variations in sound pressure level (SPL) in the source room, and an increase in SPL of 20 dB at a wal...... shown a reduction in sound transmission of up to 10 dB at resonance frequencies and a reduction at broadband noise of 3 – 5 dB at frequencies up to 100 Hz. The ideas and understanding of the CABS system will also be given....... is possible at modal frequencies. For that reason the modal frequencies in the source room will also have big impact on the transmission to neighbour rooms. These low frequency resonance frequencies are very audible in the source room but also in neighbour rooms as a booming bass. CABS (Controlled Acoustic...

  15. 75 FR 69912 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2010-11-16

    ... Safety: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety..., 2010, PHMSA published a Control Room Management/Human Factors notice of proposed rulemaking (NPRM... to expedite the program implementation deadlines of the Control Room Management/Human Factors rule...

  16. 75 FR 5536 - Pipeline Safety: Control Room Management/Human Factors, Correction

    Science.gov (United States)

    2010-02-03

    ... Safety: Control Room Management/Human Factors, Correction AGENCY: Pipeline and Hazardous Materials Safety... Regulations to address human factors and other aspects of control room management for pipelines where... 63310) entitled ``Pipeline Safety: Control Room Management/Human Factors.'' This final rule...

  17. Development of efficiency indicators of operating room management for multi-institutional comparisons.

    Science.gov (United States)

    Tanaka, Masayuki; Lee, Jason; Ikai, Hiroshi; Imanaka, Yuichi

    2013-04-01

    The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-institutional comparisons. The aim of this study was to develop indicators of OR management efficiency that would take into account differences in hospital size and manpower, which may then be applied to multi-institutional comparisons. Using administrative data from 224 hospitals in Japan from 2008 to 2010, we performed four multiple linear regression analyses at the hospital level, in which the dependent variables were the number of operations per OR per month, procedural fees per OR per month, total utilization times per OR per month and total fees per OR per month for each of the models. The expected values of these four indicators were produced using multiple regression analysis results, adjusting for differences in hospital size and manpower, which are beyond the control of process owners' management. However, more than half of the variations in three of these four indicators were shown to be explained by differences in hospital size and manpower. Using the ratio of observed to expected values (OE ratio), as well as the difference between the two values (OE difference) allows hospitals to identify weaknesses in efficiency with more validity when compared to unadjusted indicators. The new indicators may support the improvement and sustainment of a high-quality health care system. © 2012 Blackwell Publishing Ltd.

  18. Telementoring systems in the operating room: a new approach in medical training

    Directory of Open Access Journals (Sweden)

    Juan P. Wachs

    2013-12-01

    Full Text Available This paper discusses the challenges and innovations related to the use of telementoring systems in the operating room. Most of the systems presented leverage on three types of interaction channels: audio, visual and physical. The audio channel enables the mentor to verbally instruct the trainee, and allows the trainee to ask questions. The visual channel is used to deliver annotations, alerts and other messages graphically to the trainee during the surgery. These visual representations are often displayed through a telestrator. The physical channel has been used in laparoscopic procedures by partially controlling the laparoscope through force-feedback. While in face to face instruction, the mentor produces gestures to convey certain aspects of the surgical instruction, there is not equivalent of this form of physical interaction between the mentor and trainee in open surgical procedures in telementoring systems. Even that the trend is to perform more minimally invasive surgery (MIS, trauma surgeries are still necessary, where initial resuscitation and stabilization of the patient in a timely manner is crucial. This paper presents a preliminary study conducted at the Indiana University Medical School and Purdue University, where initial lexicons of surgical instructive gestures (SIGs were determined through systematic observation when mentor and trainee operate together. The paper concludes with potential ways to convey gestural information through surgical robots.

  19. Telementoring systems in the operating room: a new approach in medical training.

    Science.gov (United States)

    Wachs, Juan P; Gomez, Gerardo

    2013-01-01

    This paper discusses the challenges and innovations related to the use of telementoring systems in the operating room. Most of the systems presented leverage on three types of interaction channels: audio, visual and physical. The audio channel enables the mentor to verbally instruct the trainee, and allows the trainee to ask questions. The visual channel is used to deliver annotations, alerts and other messages graphically to the trainee during the surgery. These visual representations are often displayed through a telestrator. The physical channel has been used in laparoscopic procedures by partially controlling the laparoscope through force-feedback. While in face to face instruction, the mentor produces gestures to convey certain aspects of the surgical instruction, there is not equivalent of this form of physical interaction between the mentor and trainee in open surgical procedures in telementoring systems. Even that the trend is to perform more minimally invasive surgery (MIS), trauma surgeries are still necessary, where initial resuscitation and stabilization of the patient in a timely manner is crucial. This paper presents a preliminary study conducted at the Indiana University Medical School and Purdue University, where initial lexicons of surgical instructive gestures (SIGs) were determined through systematic observation when mentor and trainee operate together. The paper concludes with potential ways to convey gestural information through surgical robots.

  20. A norm utilisation for scarce hospital resources: Evidence from operating rooms in a Dutch university hospital

    NARCIS (Netherlands)

    van Houdenhoven, Mark; Hans, Elias W.; Klein, Jan; Wullink, Gerhard; Kazemier, Geert

    2007-01-01

    Background: Utilisation of operating rooms is high on the agenda of hospital managers and researchers. Many efforts in the area of maximising the utilisation have been focussed on finding the holy grail of 100% utilisation. The utilisation that can be realised, however, depends on the patient mix an

  1. Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling

    NARCIS (Netherlands)

    Houdenhoven, van M.; Oostrum, van J.M.; Hans, E.W.; Wullink, G.; Kazemier, G.

    2013-01-01

    BACKGROUND: An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques.

  2. Emotional intelligence in the operating room: analysis from the Boston Marathon bombing.

    Science.gov (United States)

    Chang, Beverly P; Vacanti, Joshua C; Michaud, Yvonne; Flanagan, Hugh; Urman, Richard D

    2014-01-01

    The Boston Marathon terrorist bombing that occurred on April 15, 2013 illustrates the importance of a cohesive, efficient management for the operating room and perioperative services. Conceptually, emotional intelligence (EI) is a form of social intelligence used by individuals in leadership positions to monitor the feelings and emotions of their team while implementing a strategic plan. To describe the experience of caring for victims of the bombing at a large tertiary care center and provide examples demonstrating the importance of EI and its role in the management of patient flow and overall care. A retrospective review of trauma data was performed. Data regarding patient flow, treatment types, treatment times, and outcomes were gathered from the hospital's electronic tracking system and subsequently analyzed. Analyses were performed to aggregate the data, identify trends, and describe the medical care. Immediately following the bombing, a total of 35 patients were brought to the emergency department (ED) with injuries requiring immediate medical attention. 10 of these patients went directly to the operating room on arrival to the hospital. The first victim was in an operating room within 21 minutes after arrival to the ED. The application of EI in managerial decisions helped to ensure smooth transitions for victims throughout all stages of their perioperative care. EI provided the fundamental groundwork that allowed the operating room manager and nurse leaders to establish the calm and coordinated leadership that facilitated patient care and teamwork.

  3. Activity-based costing in the operating room at Valley View Hospital.

    Science.gov (United States)

    Baker, J J; Boyd, G F

    1997-01-01

    This article presents an example of how one hospital reports the results of activity-based costing (ABC). It examines the composition and supporting assumptions of an ABC report for a particular procedure in the operating room (OR). It describes management uses of the information generated. It comments upon how the continuous quality improvement (CQI) is synchronized with the ABC reporting.

  4. Room Temperature Operation of a Buried Heterostructure Photonic Crystal Quantum Cascade Laser

    CERN Document Server

    Peretti, R; Wolf, J M; Bonzon, C; Süess, M J; Lourdudoss, S; Metaferia, W; Beck, M; Faist, J

    2015-01-01

    We demonstrated room temperature operation of deep etched photonic crystal quantum cascade laser emitting around 8.5 micron. We fabricated buried heterostructure photonic crystals, resulting in single mode laser emission on a high order slow Bloch modes of the photonic crystal, between high symmetry points of the Brillouin.

  5. Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling

    NARCIS (Netherlands)

    van Houdenhoven, M.; van Oostrum, J.M.; Hans, Elias W.; Wullink, Gerhard; Kazemier, G.

    2013-01-01

    BACKGROUND: An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques.

  6. Natural Rubber Latex Hypersensitivity with Skin Prick Test in Operating Room Personnel

    Directory of Open Access Journals (Sweden)

    Seyed Hessamedin Nabavizadeh

    2009-12-01

    Full Text Available Hypersensitivity reactions to natural rubber latex have increased recently, especially among people with high exposure to latex allergens. Hypersensitivity reactions to latex are related to many conditions like occupational asthma. Our study was performed to determine the prevalence of hypersensitivity to natural rubber latex and potential food cross reactions in operation room personnel in Shiraz hospitals. In this cross-sectional, descriptive study, 580 operation room personnel filled out our questionnaire which included data about their personal history, symptoms of latex hypersensitivity, and other related allergies such as food hypersensitivity. An informed consent was obtained and skin prick tests were performed for natural rubber latex and potential food cross reactions (kiwi, banana, and potato. The obtained data were analyzed by SPSS and Chi-square test.Results: 104 (17.9% of the operating room personnel showed positive latex skin tests. We revealed a significant correlation between those with positive skin tests to latex with atopia, urthicaria, and food hypersensitivity. The prevalence did not vary by sex, age, education, surgical and non-surgical gloves users, or history of contact dermatitis. Latex hypersensitivity is common among operation room personnel. Evaluation of symptoms and prediction of future diseases necessitate screening tests in individuals at risk.

  7. Bilateral Control - Operational enhancements

    OpenAIRE

    Altınışık, Ahmet; Altinisik, Ahmet

    2006-01-01

    A succinct definition of the word bilateral is having two sides [1]. In robotics the term bilateral control is used to define the specific interaction of two systems by means of position and/or force. Bilateral systems are composed of two sides named master and slave side. The aim of such an arrangement is such that position command dictated by master side is followed by a slave side, and at the same time the force sensation of the remote environment experienced by slave is transferred to the...

  8. Room temperature coherent control of coupled single spins in solid

    CERN Document Server

    Gaebel, T; Popa, I; Wittmann, C; Neumann, P; Jelezko, F; Rabeau, J R; Stavrias, N; Greentree, A D; Prawer, S; Meijer, J; Twamley, J; Hemmer, P R; Wrachtrup, J

    2006-01-01

    Coherent coupling between single quantum objects is at the heart of modern quantum physics. When coupling is strong enough to prevail over decoherence, it can be used for the engineering of correlated quantum states. Especially for solid-state systems, control of quantum correlations has attracted widespread attention because of applications in quantum computing. Such coherent coupling has been demonstrated in a variety of systems at low temperature1, 2. Of all quantum systems, spins are potentially the most important, because they offer very long phase memories, sometimes even at room temperature. Although precise control of spins is well established in conventional magnetic resonance3, 4, existing techniques usually do not allow the readout of single spins because of limited sensitivity. In this paper, we explore dipolar magnetic coupling between two single defects in diamond (nitrogen-vacancy and nitrogen) using optical readout of the single nitrogen-vacancy spin states. Long phase memory combined with a d...

  9. Procedure and information displays in advanced nuclear control rooms: experimental evaluation of an integrated design.

    Science.gov (United States)

    Chen, Yue; Gao, Qin; Song, Fei; Li, Zhizhong; Wang, Yufan

    2017-08-01

    In the main control rooms of nuclear power plants, operators frequently have to switch between procedure displays and system information displays. In this study, we proposed an operation-unit-based integrated design, which combines the two displays to facilitate the synthesis of information. We grouped actions that complete a single goal into operation units and showed these operation units on the displays of system states. In addition, we used different levels of visual salience to highlight the current unit and provided a list of execution history records. A laboratory experiment, with 42 students performing a simulated procedure to deal with unexpected high pressuriser level, was conducted to compare this design against an action-based integrated design and the existing separated-displays design. The results indicate that our operation-unit-based integrated design yields the best performance in terms of time and completion rate and helped more participants to detect unexpected system failures. Practitioner Summary: In current nuclear control rooms, operators frequently have to switch between procedure and system information displays. We developed an integrated design that incorporates procedure information into system displays. A laboratory study showed that the proposed design significantly improved participants' performance and increased the probability of detecting unexpected system failures.

  10. Crew resource management improved perception of patient safety in the operating room.

    Science.gov (United States)

    Gore, Dennis C; Powell, Jennifer M; Baer, Jennifer G; Sexton, Karen H; Richardson, C Joan; Marshall, David R; Chinkes, David L; Townsend, Courtney M

    2010-01-01

    To improve safety in the operating theater, a company of aviation pilots was employed to guide implementation of preprocedural briefings. A 5-point Likert scale survey that assessed the attitudes of operating room personnel toward patient safety was distributed before and 6 months following implementation of the briefings. Using Mann-Whitney analysis, the survey showed a significant (P perception of patient safety, which was largely demonstrated by nursing personnel.

  11. Report for Task 8.4: Development of Control Room Layout Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Robert [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    Idaho National Laboratory (INL) has contracted Institutt for Energiteknikk (IFE) to support in the development of an end state vision for the US Nuclear industry and in particular for a utility that is currently moving forward with a control room modernization project. This support includes the development of an Overview display and technical support in conducting an operational study. Development of operational scenarios to be conducted using a full scope simulator at the INL HSSL. Additionally IFE will use the CREATE modelling tool to provide 3-D views of the potential and possible end state view after the completion of digital upgrade project.

  12. Music and ambient operating room noise in patients undergoing spinal anesthesia.

    Science.gov (United States)

    Ayoub, Chakib M; Rizk, Laudi B; Yaacoub, Chadi I; Gaal, Dorothy; Kain, Zeev N

    2005-05-01

    Previous studies have indicated that music decreases intraoperative sedative requirements in patients undergoing surgical procedures under regional anesthesia. In this study we sought to determine whether this decrease in sedative requirements results from music or from eliminating operating room (OR) noise. A secondary aim of the study was to examine the relationship of response to intraoperative music and participants' culture (i.e., American versus Lebanese). Eighty adults (36 American and 54 Lebanese) undergoing urological procedures with spinal anesthesia and patient-controlled IV propofol sedation were randomly assigned to intraoperative music, white noise, or OR noise. We found that, controlling for ambient OR noise, intraoperative music decreases propofol requirements (0.004 +/- 0.002 mg . kg(-1) . min(-1) versus 0.014 +/- 0.004 mg . kg(-1) . min(-1) versus 0.012 +/- 0.002 mg . kg(-1) . min(-1); P = 0.026). We also found that, regardless of group assignment, Lebanese patients used less propofol as compared with American patients (0.005 +/- 0.001 mg . kg(-1) . min(-1) versus 0.017 +/- 0.003 mg . kg(-1) . min(-1); P = 0.001) and that, in both sites, patients in the music group required less propofol (P noise, intraoperative music decreases propofol requirements of both Lebanese and American patients who undergo urological surgery under spinal anesthesia.

  13. Development of DMC controllers for temperature control of a room deploying the displacement ventilation HVAC system

    Directory of Open Access Journals (Sweden)

    Zhicheng Li, Ramesh K. Agarwal, Huijun Gao

    2013-01-01

    Full Text Available In this paper, by developing a new Dynamic Matrix Control (DMC method, we develop a controller for temperature control of a room cooled by a displacement ventilation HVAC system. The fluid flow and heat transfer inside the room are calculated by solving the Reynolds-Averaged Navier-Stokes (RANS equations including the effects of buoyancy in conjunction with a two-equation realizable k - epsilon turbulence model. Thus the physical environment is represented by a nonlinear system of partial differential equations. The system also has a large time delay because of the slowness of the heat exchange. The goal of the paper is to develop a controller that will maintain the temperature at three points near three different walls in a room within the specified upper and lower bounds. In order to solve this temperature control problem at three different points in the room, we develop a special DMC method. The results show that the newly developed DMC controller is an effective controller to maintain temperature within desired bounds at multiple points in the room and also saves energy when compared to other controllers. This DMC method can also be employed to develop controllers for other HVAC systems such as the overhead VAV (Variable Air Volume system and the radiant cooling hydronic system.

  14. Development of DMC controllers for temperature control of a room deploying the displacement ventilation HVAC system

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhicheng; Agarwal, Ramesh K. [Department of Mechanical Engineering and Materials Science, Washington University in Saint Louis, MO 63130 (United States); Gao, Huijun [Research Institute of Intelligent Control and Systems, Harbin Institute of Technology, Harbin 150001 (China)

    2013-07-01

    In this paper, by developing a new Dynamic Matrix Control (DMC) method, we develop a controller for temperature control of a room cooled by a displacement ventilation HVAC system. The fluid flow and heat transfer inside the room are calculated by solving the Reynolds-Averaged Navier-Stokes (RANS) equations including the effects of buoyancy in conjunction with a two-equation realizable k - epsilon turbulence model. Thus the physical environment is represented by a nonlinear system of partial differential equations. The system also has a large time delay because of the slowness of the heat exchange. The goal of the paper is to develop a controller that will maintain the temperature at three points near three different walls in a room within the specified upper and lower bounds. In order to solve this temperature control problem at three different points in the room, we develop a special DMC method. The results show that the newly developed DMC controller is an effective controller to maintain temperature within desired bounds at multiple points in the room and also saves energy when compared to other controllers. This DMC method can also be employed to develop controllers for other HVAC systems such as the overhead VAV (Variable Air Volume) system and the radiant cooling hydronic system.

  15. Human factors dimensions in the evolution of increasingly automated control rooms for near-earth satellites

    Science.gov (United States)

    Mitchell, C. M.

    1982-01-01

    The NASA-Goddard Space Flight Center is responsible for the control and ground support for all of NASA's unmanned near-earth satellites. Traditionally, each satellite had its own dedicated mission operations room. In the mid-seventies, an integration of some of these dedicated facilities was begun with the primary objective to reduce costs. In this connection, the Multi-Satellite Operations Control Center (MSOCC) was designed. MSOCC represents currently a labor intensive operation. Recently, Goddard has become increasingly aware of human factors and human-machine interface issues. A summary is provided of some of the attempts to apply human factors considerations in the design of command and control environments. Current and future activities with respect to human factors and systems design are discussed, giving attention to the allocation of tasks between human and computer, and the interface for the human-computer dialogue.

  16. Human factors dimensions in the evolution of increasingly automated control rooms for near-earth satellites

    Science.gov (United States)

    Mitchell, C. M.

    1982-01-01

    The NASA-Goddard Space Flight Center is responsible for the control and ground support for all of NASA's unmanned near-earth satellites. Traditionally, each satellite had its own dedicated mission operations room. In the mid-seventies, an integration of some of these dedicated facilities was begun with the primary objective to reduce costs. In this connection, the Multi-Satellite Operations Control Center (MSOCC) was designed. MSOCC represents currently a labor intensive operation. Recently, Goddard has become increasingly aware of human factors and human-machine interface issues. A summary is provided of some of the attempts to apply human factors considerations in the design of command and control environments. Current and future activities with respect to human factors and systems design are discussed, giving attention to the allocation of tasks between human and computer, and the interface for the human-computer dialogue.

  17. Numerical Study on Effects of Door-Opening on Airflow Patterns and Dynamic Cross-Contamination in an ISO Class 5 Operating Room

    Institute of Scientific and Technical Information of China (English)

    DONG Shuyun; TU Guangbei; CAO Rongguang; YU Zhenfeng

    2009-01-01

    The contamination diffusion to the operating room when the door is open was simulated with a computational fluid dynamic (CFD) method,to give the extent of the contamination diffusion.The influence of the door-opening procedure was ignored since the door of the operating room is normally a sliding one.The flow field in the case of the 16 s course of opening the door was simulated.The simulated and the experimental results demonstrate that the extent of the contamination diffusion is around 1.5 m when there is no temperature difference between indoor and outdoor,and there is hardly any contamination diffusion when the temperature difference is 1 ℃.It can be concluded that the positive pressure difference in the operating room lost its function in preventing the contamination when the door is open.That the temperature of corridor is lower than that of operating room contributes to contamination control.Keeping 1 ℃ temperature difference between corridor and operating room and increasing positive pressure and air flow are suggested.It is more secure to set up an anteroom if persons come in or out of the operation room at the course of surgery.

  18. Diffusion and Evaporation-Controlled Emission in Ventilated Rooms

    DEFF Research Database (Denmark)

    Topp, Claus

    In emission studies reported in literature little effort has been made to investigate the emission from building materials in ventilated enclosures from a fluid dynamics point of view. Furthermore, most of the existing emission models are empirical relations that are based on specific pollutants...... change rate, local air velocity and local turbulence intensity as the mass transfer coefficient increases in proportion to these parameters. The experimental results moreover exhibit the behaviour of a diffusion-controlled emission process at the end of the experiments. A simplified version of the model...... and sources. This work provides an investigation based on fundamental fluid dynamics and mass transfer theory to obtain a general understanding of the mechanisms involved in the emission from building materials in ventilated rooms. In addition, a generally applicable model for prediction of surface emission...

  19. Remote Operations Control Center (ROCC)

    Science.gov (United States)

    1997-01-01

    Students at Rensselaer Polytechnic Institute (RPI) in Troy, NY, monitor the progress of the Isothermal Dendritic Growth Experiment (IDGE) during the U.S. Microgravity Payload-4 (USMP-4) mission (STS-87, Nov. 19 - Dec. 5, 1997). Remote Operation Control Center (ROCC) like this one will become more common during operations with International Space Station. IDGE, flown on three Space Shuttle missions, is yielding new insights into virtually all industrially relevant metal and alloy forming operations. Photo credit: Renssenlaer Polythnic Institute (RPI)

  20. Obesity increases operating room time for lobectomy in the society of thoracic surgeons database.

    Science.gov (United States)

    St Julien, Jamii B; Aldrich, Melinda C; Sheng, Shubin; Deppen, Stephen A; Burfeind, William R; Putnam, Joe B; Lambright, Eric S; Nesbitt, Jonathan C; Grogan, Eric L

    2012-12-01

    Obesity has become a major epidemic in the United States. Although research suggests obesity does not increase major morbidity or mortality after thoracic operations, it likely results in greater use of health care resources. We examined all patients in The Society of Thoracic Surgeons General Thoracic Surgery database with primary lung cancer who underwent lobectomy from 2006 to 2010. We investigated the impact of body mass index (BMI) on total operating room time using a linear mixed-effects regression model and multiple imputations to account for missing data. Secondary outcomes included postoperative length of stay and 30-day mortality. Covariates included age, sex, race, forced expiratory volume, smoking status, Zubrod score, prior chemotherapy or radiation, steroid use, number of comorbidities, surgical approach, hospital lobectomy volume, hospital percent obesity, and the addition of mediastinoscopy or wedge resection. A total of 19,337 patients were included. The mean BMI was 27.3 kg/m2, with 4,898 patients (25.3%) having a BMI of 30 kg/m2 or greater. The mean total operating room time, length of stay, and 30-day mortality were 240 minutes, 6.7 days, and 1.8%, respectively. For every 10-unit increase in BMI, mean operating room time increased by 7.2 minutes (range, 4.8 to 8.4 minutes; pobese patients did not affect the association between BMI and operative time. Body mass index was not associated with 30-day mortality or increased length of stay. Increased BMI is associated with increased total operating room time, regardless of institutional experience with obese patients. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Design and modernization of control rooms according to new I and C systems based on HFE principles

    Energy Technology Data Exchange (ETDEWEB)

    Rejas, Luis; Larraz, Javier, E-mail: lrejas@tecnatom.e, E-mail: jlarraz@tecnatom.e [Tecnatom S.A., San Sebastian de los Reyes, Madrid (Spain). New Control Room Design Dept.; Ortega, Fernando, E-mail: fortega@tecnatom.e [Tecnatom S.A., San Sebastian de los Reyes, Madrid (Spain). Control Room and Simulation Dept.

    2011-07-01

    The use of new digital I and C systems in the design of new nuclear power plants, as well as the modernization of existing facilities, implies relevant changes in the control room design. New I and C systems provide new features that affect the control room operating concept. Therefore, a detailed analysis is required to take into consideration all the operating and human factors aspects. Based on Tecnatom experience in the field, this article presents the methodological approach used as well as the most relevant aspects of this kind of project. (author)

  2. Comparison of the Effect of Noise Levels on Stress Response in Two Different Operation Groups in an Orthopedic Surgery Room

    Directory of Open Access Journals (Sweden)

    Hasibe Baytan Yildiz

    2016-09-01

    Full Text Available Aim: The aim of this randomized, single-blinded study was to evaluate the effects of noise on hemodynamic and neuroendocrine stress response by measuring the level of noise in the surgery rooms of patients undergoing knee operations under neuroaxial anesthesia. Gerec ve Yontem: We compared patient responses from two groups of patients: those undergoing knee operations in a surgery room where the noise level (measured in decibels is high, and those undergoing meniscus operations in a surgery room with lower noise levels. The STAI, the State-Trait Anxiety Inventory (STAI-1, and the anxiety test (STAI-2wereperformed at preoperative and postoperative periods. 20 ml of blood sample was taken for basal, intraoperative 30th minute, and postoperative 1st hour measurements. Systolic, diastolic, and mean arterial blood pressures were found to be higher in the high noise level group. ACTH levels were increased during the early postoperative period and became normal during the late postoperative period in the high noise level group whereas ACTH levels were significantly decreased in the low-noise level group. Basal cortisol levels were significantly higher in the high noise level group. HCRP, an inflammatory response mediator was found to be decreased in both groups. Early and late blood glucose levels were significantly higher in the high noise group. There was a greater increase in early and late blood glucose levels in the high noise group. In the postoperative period, although the state-trait anxiety inventory (STAI-2 levels being higher in patients subject to noisier environment determines how people feel independent of the conditions and state they are in, this result made us consider that the noise the patients were subjected to in the intraoperative period may cause a stress response. Discussion: As a result we believe that standard noise levels should be achieved by reducing the factors causing high noise levels in the operating room. This will

  3. Expert operator preferences in remote manipulator control systems

    Energy Technology Data Exchange (ETDEWEB)

    Sundstrom, E. [Human Machine Interfaces, Inc., Knoxville, TN (United States); Draper, J.V. [Oak Ridge National Lab., TN (United States); Fausz, A.; Woods, H. [Univ. of Tennessee, Knoxville, TN (United States)

    1995-06-01

    This report describes a survey of expert remote manipulator operators designed to identify features of control systems related to operator efficiency and comfort. It provides information for designing the control center for the Single-Shell Tank Waste Retrieval Manipulator System (TWRMS) Test Bed, described in a separate report. Research questions concerned preferred modes of control, optimum work sessions, sources of operator fatigue, importance of control system design features, and desired changes in control rooms. Participants comprised four expert remote manipulator operators at Oak Ridge National Laboratory, who individually have from 9 to 20 years of experience using teleoperators. The operators had all used rate and position control, and all preferred bilateral (force-reflecting) position control. They reported spending an average of 2.75 h in control of a teleoperator system during a typical shift. All were accustomed to working in a crew of two and alternating control and support roles in 2-h rotations in an 8-h shift. Operators reported that fatigue in using remote manipulator systems came mainly from watching TV monitors and making repetitive motions. Three of four experienced symptoms, including headaches and sore eyes, wrists, and back. Of 17 features of control rooms rated on importance, highest ratings went to comfort and support provided by the operator chair, location of controls, location of video monitors, video image clarity, types of controls, and control modes. When asked what they wanted to change, operators said work stations designed for comfort; simpler, lighter hand-controls; separate controls for each camera; better placement of remote camera; color monitors; and control room layouts that support crew interaction. Results of this small survey reinforced the importance of ergonomic factors in remote manipulation.

  4. Relationship Between Operating Room Teamwork, Contextual Factors, and Safety Checklist Performance.

    Science.gov (United States)

    Singer, Sara J; Molina, George; Li, Zhonghe; Jiang, Wei; Nurudeen, Suliat; Kite, Julia G; Edmondson, Lizabeth; Foster, Richard; Haynes, Alex B; Berry, William R

    2016-10-01

    Studies show that using surgical safety checklists (SSCs) reduces complications. Many believe SSCs accomplish this by enhancing teamwork, but evidence is limited. Our study sought to relate teamwork to checklist performance, understand how they relate, and determine conditions that affect this relationship. Using 2 validated tools for observing and coaching operating room teams, we evaluated the association between checklist performance with surgeon buy-in and 4 domains of surgical teamwork: clinical leadership, communication, coordination, and respect. Hospital staff in 10 South Carolina hospitals observed 207 procedures between April 2011 and January 2013. We calculated levels of checklist performance, buy-in, and measures of teamwork, and evaluated their relationship, controlling for patient and case characteristics. Few teams completed most or all SSC items. Teams more often completed items considered procedural "checks" than conversation "prompts." Surgeon buy-in, clinical leadership, communication, a summary measure of teamwork overall, and observers' teamwork ratings positively related to overall checklist completion (multivariable model estimates from 0.04, p teamwork and surgeon buy-in related positively to completing more conversation prompts; none related significantly to procedural checks (estimates from 0.10, p teamwork characterized by shared clinical leadership, open communication, active coordination, and mutual respect were critical in prompting case-related conversations, but not in completing procedural checks. Findings highlight the importance of surgeon engagement and high-quality, consistent teamwork for promoting checklist use and ensuring a safe surgical environment. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. 75 FR 67450 - Pipeline Safety: Control Room Management Implementation Workshop

    Science.gov (United States)

    2010-11-02

    ... associated with fatigue management and maximum hours of service, alarm management, and adequate information... Specifics. (3) Fatigue and Maximum Hours of Service (panel). (4) Alarm Management (panel). (5) Roles and... risk associated with controller fatigue. In addition, certain operators must define the roles and...

  6. Undergraduate surgical nursing preparation and guided operating room experience: A quantitative analysis.

    Science.gov (United States)

    Foran, Paula

    2016-01-01

    The aim of this research was to determine if guided operating theatre experience in the undergraduate nursing curricula enhanced surgical knowledge and understanding of nursing care provided outside this specialist area in the pre- and post-operative surgical wards. Using quantitative analyses, undergraduate nurses were knowledge tested on areas of pre- and post-operative surgical nursing in their final semester of study. As much learning occurs in nurses' first year of practice, participants were re-tested again after their Graduate Nurse Program/Preceptorship year. Participants' results were compared to the model of operating room education they had participated in to determine if there was a relationship between the type of theatre education they experienced (if any) and their knowledge of surgical ward nursing. Findings revealed undergraduates nurses receiving guided operating theatre experience had a 76% pass rate compared to 56% with non-guided or no experience (p < 0.001). Graduates with guided operating theatre experience as undergraduates or graduate nurses achieved a 100% pass rate compared to 53% with non-guided or no experience (p < 0.001). The research informs us that undergraduate nurses achieve greater learning about surgical ward nursing via guided operating room experience as opposed to surgical ward nursing experience alone.

  7. Review of advanced control rooms: Methodological considerations for the use of HFE guidelines

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M.

    1994-03-01

    Control rooms for advanced nuclear power plants use advanced human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator`s overall role in the system and the ways in which operators interact with the system. The US Nuclear Regulatory Commission (NRC) reviews HSIs to ensure that they are designed to accepted human factors engineering (HFE) principles. The principal review guidance, however, is more than ten-years old (US NRC, 1981). Accordingly, an Advanced HSI Design Review Guideline (DRG) was developed to provide criteria for these reviews. The DRG contains seven major sections: Information Display, User-System Interaction, Process Control and Input Devices, Alarms, Analysis and Decision Aids, Inter-Personnel Communication, and Workplace Design (see O`Hara & Brown, 1993). The purpose of this paper is to describe the methodology for DRG use.

  8. A HUMAN AUTOMATION INTERACTION CONCEPT FOR A SMALL MODULAR REACTOR CONTROL ROOM

    Energy Technology Data Exchange (ETDEWEB)

    Le Blanc, Katya; Spielman, Zach; Hill, Rachael

    2017-06-01

    Many advanced nuclear power plant (NPP) designs incorporate higher degrees of automation than the existing fleet of NPPs. Automation is being introduced or proposed in NPPs through a wide variety of systems and technologies, such as advanced displays, computer-based procedures, advanced alarm systems, and computerized operator support systems. Additionally, many new reactor concepts, both full scale and small modular reactors, are proposing increased automation and reduced staffing as part of their concept of operations. However, research consistently finds that there is a fundamental tradeoff between system performance with increased automation and reduced human performance. There is a need to address the question of how to achieve high performance and efficiency of high levels of automation without degrading human performance. One example of a new NPP concept that will utilize greater degrees of automation is the SMR concept from NuScale Power. The NuScale Power design requires 12 modular units to be operated in one single control room, which leads to a need for higher degrees of automation in the control room. Idaho National Laboratory (INL) researchers and NuScale Power human factors and operations staff are working on a collaborative project to address the human performance challenges of increased automation and to determine the principles that lead to optimal performance in highly automated systems. This paper will describe this concept in detail and will describe an experimental test of the concept. The benefits and challenges of the approach will be discussed.

  9. Operational Control of Internal Transport

    NARCIS (Netherlands)

    J.R. van der Meer (Robert)

    2000-01-01

    textabstractOperational Control of Internal Transport considers the control of guided vehicles in vehicle-based internal transport systems found in facilities such as warehouses, production plants, distribution centers and transshipment terminals. The author's interest of research having direct use

  10. IT Strategic and Operational Controls

    CERN Document Server

    Kyriazoglou, J

    2010-01-01

    This book provides a comprehensive guide to implementing an integrated and flexible set of IT controls in a systematic way. It can help organisations to formulate a complete culture for all areas which must be supervised and controlled; allowing them to simultaneously ensure a secure, high standard whilst striving to obtain the strategic and operational goals of the company.

  11. Robust isothermal electric control of exchange bias at room temperature

    Science.gov (United States)

    Binek, Christian

    2011-03-01

    Voltage-controlled spintronics is of particular importance to continue progress in information technology through reduced power consumption, enhanced processing speed, integration density, and functionality in comparison with present day CMOS electronics. Almost all existing and prototypical solid-state spintronic devices rely on tailored interface magnetism, enabling spin-selective transmission or scattering of electrons. Controlling magnetism at thin-film interfaces, preferably by purely electrical means, is a key challenge to better spintronics. Currently, most attempts to electrically control magnetism focus on potentially large magnetoelectric effects of multiferroics. We report on our interest in magnetoelectric Cr 2 O3 (chromia). Robust isothermal electric control of exchange bias is achieved at room temperature in perpendicular anisotropic Cr 2 O3 (0001)/CoPd exchange bias heterostructures. This discovery promises significant implications for potential spintronics. From the perspective of basic science, our finding serves as macroscopic evidence for roughness-insensitive and electrically controllable equilibrium boundary magnetization in magnetoelectric antiferromagnets. The latter evolves at chromia (0001) surfaces and interfaces when chromia is in one of its two degenerate antiferromagnetic single domain states selected via magnetoelectric annealing. Theoretical insight into the boundary magnetization and its role in electrically controlled exchange bias is gained from first-principles calculations and general symmetry arguments. Measurements of spin-resolved ultraviolet photoemission, magnetometry at Cr 2 O3 (0001) surfaces, and detailed investigations of the unique exchange bias properties of Cr 2 O3 (0001)/CoPd including its electric controllability provide macroscopically averaged information about the boundary magnetization of chromia. Laterally resolved X-ray PEEM and temperature dependent MFM reveal detailed microscopic information of the chromia

  12. Low frequency sound reproduction in irregular rooms using CABS (Control Acoustic Bass System)

    DEFF Research Database (Denmark)

    Celestinos, Adrian; Nielsen, Sofus Birkedal

    2011-01-01

    loudspeakers well positioned at the end of the room a virtual array is formed propagating plane waves along the length of the room in one direction. This will correct the sound field distribution in the room. When plane wave arrives to the end wall two more loudspeakers have to be placed connected......Early investigations on low frequency sound reproduction in rectangular rooms using CABS (Controlled Acoustic Bass System) have shown good results on simulations and measurements in real rooms. CABS takes the advantage of having a rectangular room with parallel walls. By using two low frequency...... with the same signal in counter phase and with a delay corresponding to approximately the length of the room. This is to cancel the reflection and maintain the plane wave propagating along the room. Real life rooms are not necessary rectangular and can be of different shapes. In this paper simulations...

  13. LOW ENDOPHTHALMITIS RATES AFTER INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS IN AN OPERATION ROOM

    DEFF Research Database (Denmark)

    Freiberg, Florentina J; Brynskov, Troels; Munk, Marion R

    2017-01-01

    PURPOSE: To evaluate the rate of presumed endophthalmitis (EO) after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in three European hospitals performed in an operation room (OR) under sterile conditions. METHODS: A retrospective multicenter study between 2003 and 2016...... at three European sites, City Hospital Triemli Zurich, Switzerland (CHT), Zealand University Hospital Roskilde, Denmark (ZUH) and University Clinic Bern, Switzerland (UCB). Intravitreal injection (IVI) database of each department was reviewed. All anti-vascular endothelial growth factor injections were.......0074% per injection (95% CI: 0.0070-0.0078%). Positive cultures were found in 4 out of 10 presumed endophthalmitis cases. CONCLUSION: The standardized sterile technique in an operation room with laminar airflow showed very low rates of endophthalmitis at three European sites....

  14. Single-use surgical clothing system for reduction of airborne bacteria in the operating room.

    Science.gov (United States)

    Tammelin, A; Ljungqvist, B; Reinmüller, B

    2013-07-01

    It is desirable to maintain a low bacterial count in the operating room air to prevent surgical site infection. This can be achieved by ventilation or by all staff in the operating room wearing clothes made from low-permeable material (i.e. clean air suits). We investigated whether there was a difference in protective efficacy between a single-use clothing system made of polypropylene and a reusable clothing system made of a mixed material (cotton/polyester) by testing both in a dispersal chamber and during surgical procedures. Counts of colony-forming units (cfu)/m(3) air were significantly lower when using the single-use clothing system in both settings. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  15. [Design of an anesthesia and micro-environment information management system in mobile operating room].

    Science.gov (United States)

    Wang, Xianwen; Liu, Zhiguo; Zhang, Wenchang; Wu, Qingfu; Tan, Shulin

    2013-08-01

    We have designed a mobile operating room information management system. The system is composed of a client and a server. A client, consisting of a PC, medical equipments, PLC and sensors, provides the acquisition and processing of anesthesia and micro-environment data. A server is a powerful computer that stores the data of the system. The client gathers the medical device data by using the C/S mode, and analyzes the obtained HL7 messages through the class library call. The client collects the micro-environment information with PLC, and finishes the data reading with the OPC technology. Experiment results showed that the designed system could manage the patient anesthesia and micro-environment information well, and improve the efficiency of the doctors' works and the digital level of the mobile operating room.

  16. [Surgery training of gynecologic residents: master and student in the operating room].

    Science.gov (United States)

    Rathat, G; Hoa, D; Gagnayre, R; Hoffet, M; Mares, P

    2008-02-01

    Describe the surgical training of gynecologic residents in the operating room, by collecting the opinion of French gynecologists. A questionnaire investigating this subject was put on a web site. Every French gynecologist could answer the questionnaire from a duration of six months. The data of the inquiry were studied by comparing five groups: residents (group 1), fellows (group 2), seniors of public hospital (group 3), and seniors of private hospitals (group 4), or, groups 2, 3 and 4 together, as Group A. Six hundred and fifty-seven gynecologists answered the inquiry. For the residents, lack of time and senior's weak educational motivation are the explanations most frequently retained in order to explain that residents do not operate. For group A, it is rather the residents' skills which is the most important fact to have residents operate. Residents more often practice surgery in general public hospital that in faculty hospital. For 31% of all the referees, heads of departments do not incite their teams to have residents operate. Nearly 25% of all the investigated believe that a man operates more than a woman in resident curriculum. Besides, by analyzing the answers of groups 1 and 2, we were able to correlate resident seniority at their first practice of 13 surgical operations. For 26% of the group A, residents operate less than they do during their own studies. Finally, all the investigated confirm the lack of surgical assessment in the resident curriculum. Decision to let the resident operate remains too dependent on senior personal appreciation and does not seem to join a strategy of training. Opinions of surgical training in the operating room is different between residents and seniors. Operating time increases when residents operate but there is no effect on quality of care. These results show again the necessity of a formal teaching and assessment, in a resident program with objectives, collecting every resident's surgery volume. These educational

  17. Room acoustic analysis of blower unit and noise control plan in the typical steel industry

    Directory of Open Access Journals (Sweden)

    2013-02-01

    Full Text Available Introduction: In the steel industry,air blowers used to supply compressed air are considered as sources of annoying noise. This study aims to acoustics analysis of theairblower workroomand sound source characteristics in order to present noise controlmeasuresinthe steel industry. .Material and Method: Measurement of noiselevel and its frequency analysis was performed usingsound levelmetermodelof CASELLA-Cell.450. Distribution of noise level in the investigated workroom in form of noise map was provided using Surfer software. In addition, acoustic analysis of workroom and control room was performed in view point of soundabsorption andinsulation. Redesignofdoor and window of controlroom and installation of soundabsorbing materialson theceiling of the workroom were proposed and the efficiency of these interventionswasestimated. .Result: The totalsound pressurelevelin the blower workroom was 95.4 dB(L and the dominant frequency was 2000Hz. Sound pressure level inside the room control was 80.1dB(A. The average absorption coefficient and reverberation time in the blower workroom was estimated equal to 0.082 Sab.m2 and 3.9 seconds respectively. These value in control room was 0.04 Sab.m2 and 3/4 seconds respectively. In control room, sound transmission loss between the two parts of the wall dividing was 13.7 dB(A. The average of noise dose in blower operators was 230%. With the installation of sound absorber on ceiling of workroom, average of absorption coefficient can increase to 0.33 Sab.m2 and sound transmission loss of the new designed door and window was estimated equal to 20dB. . Conclusion: The main cause of noise leakage in the control room was insufficient insulation properties of door and windows. By replacing the door and window and installation of sound absorbing on ceiling of workroom, the noise dose can reduce to 49.6%. New Improved door and window of control room can reduce noise dose to 69.65% solely.

  18. An Analysis of Operating Room Performance Metrics at Reynolds Army Community Hospital

    Science.gov (United States)

    2009-06-28

    the MTF does not receive any performance earnings from workload generated under the Dental inpatient and outpatient codes (CAA5 and ABFA). Also OR...increasing nursing staffing to permit completion of more cases: A case study. Anesthesia & Analgesia , 94(1), 138 - 142. Dexter, F., & Macario, A. (2002...as possible. Anesthesia & Analgesia , 94(5), 1272 - 1279. OR Metrics 54 Dexter, F., Macario, A., Traub, R.D., & Lubarsky, D.A. (2003). Operating room

  19. Implications of Surgical Training on Operating Room Throughput at Wilford Hall Medical Center

    Science.gov (United States)

    2008-06-26

    its physician specialists, 85 percent of dental specialists, and a full spectrum of other training. The medical center’s fourth mission is clinical...dedicated to training dental officers of the three services in one facility. The medical center’s support of San Antonio’s emergency medicine structure...P. (2006). Resident teaching versus the operating room schedule: An independent observer- based study of 1558 cases. Anesthesia and Analgesia , 103

  20. Predicting Correct Body Posture based on Theory of Planned Behavior in Iranian Operating Room Nurses

    OpenAIRE

    BAHAREH ABEDI; RABIOLLAH FARMANBAR1; SAEED OMIDI; MAHDI JAHANGIR BLOURCHIAN

    2015-01-01

    Due to the importance of correct posture for preventing musculoskeletal disorders, the purpose of this study was to evaluate Theory of Planned Behavior in Predicting correct Body Posture in operating room nurses.In this cross-sectional study, participants (n=100) were nurses from five hospitals located in northern Iran. Participants completed demographic data and theory of planned behavior construct Questionnaires. In addition, the researcher checked the Body Posture of nurses by Rapid Entire...

  1. Continuous-wave operation of a room-temperature Tm: YAP-pumped Ho: YAG laser

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    We report a continuous-wave (CW) 2.1-μm Ho:YAG laser operating at room temperature pumped by a diode-pumped 1.94-?m Tm:YAP laser.The maximum output power of 1.5 W is obtained from Ho:YAG laser,corresponding to Tm-to-Ho slope efficiency of 17.9% and diode-to-He conversion efficiency of 5.6%.

  2. Mirror thermal noise in laser interferometer gravitational wave detectors operating at room and cryogenic temperature

    CERN Document Server

    Franc, Janyce; Flaminio, Raffaele; Nawrodt, Ronny; Martin, Iain; Cunningham, Liam; Cumming, Alan; Rowan, Sheila; Hough, James

    2009-01-01

    Mirror thermal noise is and will remain one of the main limitations to the sensitivity of gravitational wave detectors based on laser interferometers. We report about projected mirror thermal noise due to losses in the mirror coatings and substrates. The evaluation includes all kind of thermal noises presently known. Several of the envisaged substrate and coating materials are considered. The results for mirrors operated at room temperature and at cryogenic temperature are reported.

  3. Case Study: Review of Operating Room Utilization at Mayo Clinic Arizona (MCA)

    Science.gov (United States)

    2008-05-01

    offers. The premier programs of the hospital are cancer treatment and solid organ /bone marrow transplant . (Mayo Clinic, 2007) Problem Statement In...improve revenue streams (Overdyl, Harvey, Fishman , & Shippey, 1998). Organizations have seen reduced revenues from operating room care because of lower...TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) RESIDENCY SITE ADDRESS Mayo Clinic Arizona 5777 East Mayo

  4. The effects of Chamomile tea on antioxidative biomarkers in operating room staff

    Directory of Open Access Journals (Sweden)

    Sami Ghazal

    2015-07-01

    Full Text Available Introduction: Chamomile tea (CT is an herbal tea and is served as a beneficial herbal infusion all over the world. Its major polyphenols constituents and tea-catechins have been shown to have health benefits. Operating room staff are commonly exposed to damaging factors, such as radiation, waste anesthetic gases and psychological stress. One of the most important qualities of CT is its antioxidant property. The aim of this study was to evaluate the effects of CT in reducing the oxidative stress of operative room staff that are chronically exposed to damaging factors. Methods: In this study we approached to 20 operating room personnel. The subjects drank 2 cups of CT (every cup contained 1.8730 g of chamomile and 300 ml of water daily, one cup in the morning and another in the afternoon for 21 days. A questionnaire that contained personal information was filled by each subject. Oxidative stress parameters such as total antioxidant capacity (TAC, catalase (CAT and total thiol molecules (TTG were measured 2 times: first before drinking CT at the first day and the next time after the 21st day. Results: Consumption of CT by subjects caused a significant induction in TAC (6.62 ± 0.77 vs 4.81± 0.39 ųmol/ml, P < .05 of saliva. There was not any statistically significant change in saliva TTG and CAT after 21 days of drinking CT. Conclusion: In the end we came to conclusion that CT can be a useful additional food to remove the oxidative damage that happens to operating room staff.

  5. Robust isothermal electric control of exchange bias at room temperature

    Energy Technology Data Exchange (ETDEWEB)

    He, X.; Vescovo, E.; Wang, Y.; Caruso, A.N.; Belashchenko, K.D.; Dowben, P.A.; Binek, C.

    2010-06-20

    Voltage-controlled spin electronics is crucial for continued progress in information technology. It aims at reduced power consumption, increased integration density and enhanced functionality where non-volatile memory is combined with high-speed logical processing. Promising spintronic device concepts use the electric control of interface and surface magnetization. From the combination of magnetometry, spin-polarized photoemission spectroscopy, symmetry arguments and first-principles calculations, we show that the (0001) surface of magnetoelectric Cr{sub 2}O{sub 3} has a roughness-insensitive, electrically switchable magnetization. Using a ferromagnetic Pd/Co multilayer deposited on the (0001) surface of a Cr{sub 2}O{sub 3} single crystal, we achieve reversible, room-temperature isothermal switching of the exchange-bias field between positive and negative values by reversing the electric field while maintaining a permanent magnetic field. This effect reflects the switching of the bulk antiferromagnetic domain state and the interface magnetization coupled to it. The switchable exchange bias sets in exactly at the bulk Neel temperature.

  6. Robust isothermal electric control of exchange bias at room temperature.

    Science.gov (United States)

    He, Xi; Wang, Yi; Wu, Ning; Caruso, Anthony N; Vescovo, Elio; Belashchenko, Kirill D; Dowben, Peter A; Binek, Christian

    2010-07-01

    Voltage-controlled spin electronics is crucial for continued progress in information technology. It aims at reduced power consumption, increased integration density and enhanced functionality where non-volatile memory is combined with high-speed logical processing. Promising spintronic device concepts use the electric control of interface and surface magnetization. From the combination of magnetometry, spin-polarized photoemission spectroscopy, symmetry arguments and first-principles calculations, we show that the (0001) surface of magnetoelectric Cr(2)O(3) has a roughness-insensitive, electrically switchable magnetization. Using a ferromagnetic Pd/Co multilayer deposited on the (0001) surface of a Cr(2)O(3) single crystal, we achieve reversible, room-temperature isothermal switching of the exchange-bias field between positive and negative values by reversing the electric field while maintaining a permanent magnetic field. This effect reflects the switching of the bulk antiferromagnetic domain state and the interface magnetization coupled to it. The switchable exchange bias sets in exactly at the bulk Néel temperature.

  7. 质量控制小组在手术室护理管理中的作用循证分析%The role of quality control team in the operating room nursing management evaluated by evi-dence-base analysis

    Institute of Scientific and Technical Information of China (English)

    安莉

    2015-01-01

    目的:采用循证医学方法分析质量控制小组模式在手术室中的作用,为护理管理提供参考依据。方法以质量控制小组、手术室护理管理为检索词,在中国医院数字图书馆检索中国知网CNKI期刊全文数据库、PubMed数据库,1994年1月至2014年12月期间的相关文章,按照Cochrane标准,对纳入研究进行循证分析,比较质量控制小组模式实施前后护理不良事件发生情况及护理质量评分。结果15篇符合纳入标准的研究中实施质控小组管理模式后,9篇手术室护理质量评分提高了8.32~16.22分,Meta分析差异有极显著统计学意义( Z=20.58,P<0.001);8篇手术室不良护理事件的发生率降低了66.98%~93.33%。结论质量控制小组模式能有效地提高手术室护理管理质量,减少手术室护理不良事件的发生率。%Objective To analyze the role of medicine quality control team in the operating room by evidence-based medicine in order to provide reference for nursing management.Methods We searched articles from Jan.1994 to Dec.2014 in China Hospital Knowledge Database( CHKD) of CNKI by words of quality control team and nursing management in operating room.All the included studies were assessed and summarized in Cochrane Review systematically.The adverse event and quality of care score before and after applying quality control team mode were compared.Results Thirteen studies were obtained for analysis based on inclusion criteria,a-mong which after applying quality control team mode,the quality of care score had increased 8.32~16.22 in 9 studies.Meta-analysis showed that there was significant difference ( Z=20.58, P <0.001 ) .In 8 studies, incidence of adverse event had reduced 66.98-93.33%.Conclusion The model of quality control team can improve the quality of nursing management in operating room and reduce the incidence of adverse events in operating room nursing.

  8. Low frequency sound reproduction in irregular rooms using CABS (Control Acoustic Bass System)

    DEFF Research Database (Denmark)

    Celestinos, Adrian; Nielsen, Sofus Birkedal

    2011-01-01

    Early investigations on low frequency sound reproduction in rectangular rooms using CABS (Controlled Acoustic Bass System) have shown good results on simulations and measurements in real rooms. CABS takes the advantage of having a rectangular room with parallel walls. By using two low frequency l...

  9. Assessment of nursing students' stress levels and coping strategies in operating room practice.

    Science.gov (United States)

    Yildiz Findik, Ummu; Ozbas, Ayfer; Cavdar, Ikbal; Yildizeli Topcu, Sacide; Onler, Ebru

    2015-05-01

    The aim of this study was to evaluate the stress levels and stress coping strategies of nursing students in their first operating room experience. This descriptive study was done with 126 nursing students who were having an experience in an operating room for the first time. Data were collected by using Personal Information Form, Clinical Stress Questionnaire, and Styles of Coping Inventory. The nursing students mostly had low clinical stress levels (M = 27.56, SD = 10.76) and adopted a self-confident approach in coping with stress (M = 14.3, SD = 3.58). The nursing students generally employed a helpless/self-accusatory approach among passive patterns as their clinical stress levels increased, used a self-confident and optimistic approach among active patterns as their average age increased, and those who had never been to an operating room previously used a submissive approach among passive patterns. The results showed that low levels of stress caused the nursing students to use active patterns in coping with stress, whereas increasing levels of stress resulted in employing passive patterns in stress coping. The nursing students should be ensured to maintain low levels of stress and use active patterns in stress coping.

  10. Building a Smooth Medical Service for Operating Room Using RFID Technologies

    Directory of Open Access Journals (Sweden)

    Lun-Ping Hung

    2014-01-01

    Full Text Available Due to the information technology advancement, the feasibility for the establishment of mobile medical environments has been strengthened. Using RFID to facilitate the tracing of patients’ mobile position in hospital has attracted more attentions from researchers due to the demand on advanced features. Traditionally, the management of surgical treatment is generally manually operated and there is no consistent operating procedure for patients transferring among wards, surgery waiting rooms, operating rooms, and recovery rooms, resulting in panicky and urgent transferring work among departments and, thus, leading to delays and errors. In this paper, we propose a new framework using radio frequency identification (RFID technology for a mobilized surgical process monitoring system. Through the active tag, an application management system used before, during, and after the surgical processes has been proposed. The concept of signal level matrix, SLM, was proposed to accurately identify patients and dynamically track patients’ location. By updating patient’s information real-time, the preprocessing time needed for various tasks and incomplete transfers among departments can be reduced, the medical resources can be effectively used, unnecessary medical disputes can be reduced, and more comprehensive health care environment can be provided. The feasibility and effectiveness of our proposed system are demonstrated with a number of experimental results.

  11. Room-temperature operation of mid-infrared surface-plasmon quantum cascade lasers

    Science.gov (United States)

    Bahriz, M.; Moreau, V.; Palomo, J.; Krysa, A. B.; Austin, D.; Cockburn, J. W.; Roberts, J. S.; Wilson, L. R.; Julien, F.; Colombelli, R.

    2007-04-01

    We report the pulsed, room-temperature operation of an InGaAs/AllnAs quantum cascade laser at an operating wavelength of ≈ 7.5 μm in which the optical mode is a surface-plasmon polariton excitation. The use of a silver-based electrical contact with reduced optical losses at the laser emission wavelength allows for a reduction of the laser threshold current by a factor of two relative to samples with a gold-based contact layer.

  12. The design of an embedded system for controlling humidity and temperature room

    Science.gov (United States)

    Dwi Teguh, R.; Didik Eko, S.; Laksono, Pringgo D.; Jamaluddin, Anif

    2016-11-01

    The aim of the system is to design an embedded system for maintenance confortable room. The confortable room was design by controlling temperature (on range 18 - 34 °C) and humidity (on range 40% - 70%.) of room condition. Temperature and humidity of room were maintained using four variable such as lamp for warm, water pump for distributing water vapour, a fan for air circullation and an exhaust-fan for air cleaner. The system was constucted both hardware (humidity sensor, microcontroller, pump, lamp, fan) and software (arduino IDE). The result shows that the system was perfectly performed to control room condition.

  13. Alcohol based surgical prep solution and the risk of fire in the operating room: a case report

    Directory of Open Access Journals (Sweden)

    Gupta Rajiv

    2008-04-01

    Full Text Available Abstract A few cases of fire in the operating room are reported in the literature. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, flammable drapes etc. We are reporting a case of fire in the operating room while operating on a patient with burst fracture C6 vertebra with quadriplegia. The cause of the fire was due to incomplete drying of the covering drapes with an alcohol based surgical prep solution. This paper discusses potential preventive measures to minimize the incidence of fire in the operating room.

  14. Low frequency sound field control in rectangular listening rooms using CABS (Controlled Acoustic Bass System) will also reduce sound transmission to neighbor rooms

    DEFF Research Database (Denmark)

    Nielsen, Sofus Birkedal; Celestinos, Adrian

    2011-01-01

    at resonance frequencies, but more or less at all frequencies. A time based room correction system named CABS (Controlled Acoustic Bass System) has been developed and is able to create a homogeneous sound field in the whole room at low frequencies by proper placement of multiple loudspeakers. A normal setup...... from the rear wall, and thereby leaving only the plane wave in the room. With a room size of (7.8 x 4.1 x 2.8) m. it is possible to prevent modal frequencies up to 100 Hz. An investigation has shown that the sound transmitted to a neighbour room also will be reduced if CABS is used. The principle...... and the understanding of why and how it works will also be discussed. CABS is controlled by a developed DSP (Digital Signal Processing) system....

  15. Power generation, operation, and control

    CERN Document Server

    Wood, Allen J

    2012-01-01

    A comprehensive text on the operation and control of power generation and transmission systems In the ten years since Allen J. Wood and Bruce F. Wollenberg presented their comprehensive introduction to the engineering and economic factors involved in operating and controlling power generation systems in electric utilities, the electric power industry has undergone unprecedented change. Deregulation, open access to transmission systems, and the birth of independent power producers have altered the structure of the industry, while technological advances have created a host of new opportunities

  16. Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A randomised study.

    Science.gov (United States)

    Duparc-Alegria, Nathalie; Tiberghien, Karine; Abdoul, Hendy; Dahmani, Souhayl; Alberti, Corinne; Thiollier, Anne-Francoise

    2017-04-12

    To assess the impact of a short hypnotic session on postoperative anxiety and pain in major orthopaedic surgery. Despite specific information given before a scheduled paediatric surgery, perioperative anxiety can become important. Randomised Clinical Study. The study is an open single-centre randomised clinical study comparing a "control" group versus a "hypnosis" group receiving a short hypnosis pre-induction session as additional experimental analgesic procedure. The primary endpoint was the postoperative anxiety, blindly assessed using a visual analogue scale. The study involved 120 children (age 10-18 years). The results showed no difference between control group versus hypnosis group. Twenty-four hours after surgery (Day+1), the patient's anxiety score was not different between control and hypnosis groups (median [Q1-Q3]: 1 [0; 3] vs. 0 [0; 3], respectively, p = .17). Each group experienced a significant decrease in anxiety level between the day before surgery (Day-1) and the day after surgery (Day+1) (median ([Q1-Q3]) difference of the anxiety score: 2 [4; 0] and 2 [4; 0], respectively, p < .0001 in each group). The postoperative pain scores were low and not different between groups (median [Q1-Q3]: 2 [0; 3] in control group vs. 3 [1; 3] in hypnosis group, p = .57). This randomised study on a short hypnosis session performed in the operating room prior to a major surgery showed no difference in postoperative anxiety and pain levels. The decrease in anxiety and pain levels may be due to the addition of nurse pre-operative interviews and optimisation in communication in the operating room. As postoperative anxiety level was low in both control and hypnosis groups, nurse pre-operative interviews and nurse training in hypnosis may contribute to the optimisation of global management and decrease the postoperative anxiety level. © 2017 John Wiley & Sons Ltd.

  17. Intelligent software system for the advanced control room of a nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Soon Heung; Choi, Seong Soo; Park, Jin Kyun; Heo, Gyung Young [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of); Kim, Han Gon [Korea Electric Power Research Institute, Taejon (Korea, Republic of)

    1997-12-31

    The intelligent software system for nuclear power plants (NPPs) has been conceptually designed in this study. Its design goals are to operate NPPs in an improved manner and to support operators` cognitive takes. It consists of six major modules such as {sup I}nformation Processing,{sup {sup A}}larm Processing,{sup {sup P}}rocedure Tracking,{sup {sup P}}erformance Diagnosis,{sup a}nd {sup E}vent Diagnosis{sup m}odules for operators and {sup M}alfunction Diagnosis{sup m}odule for maintenance personnel. Most of the modules have been developed for several years and the others are under development. After the completion of development, they will be combined into one system that would be main parts of advanced control rooms in NPPs. 5 refs., 4 figs. (Author)

  18. [Air conditioning units and warm air blankets in the operating room].

    Science.gov (United States)

    Kerwat, Klaus; Piechowiak, Karolin; Wulf, Hinnerk

    2013-01-01

    Nowadays almost all operating rooms are equipped with air conditioning (AC units). Their main purpose is climatization, like ventilation, moisturizing, cooling and also the warming of the room in large buildings. In operating rooms they have an additional function in the prevention of infections, especially the avoidance of postoperative wound infections. This is achieved by special filtration systems and by the creation of specific air currents. Since hypothermia is known to be an unambiguous factor for the development of postoperative wound infections, patients are often actively warmed intraoperatively using warm air blankets (forced-air warming units). In such cases it is frequently discussed whether such warm air blankets affect the performance of AC units by changing the air currents or whether, in contrast, have exactly the opposite effect. However, it has been demonstrated in numerous studies that warm air blankets do not have any relevant effect on the functioning of AC units. Also there are no indications that their use increases the rate of postoperative wound infections. By preventing the patient from experiencing hypothermia, the rate of postoperative wound infections can even be decreased thereby. © Georg Thieme Verlag Stuttgart · New York.

  19. [Implementation of a rational standard of hygiene for preparation of operating rooms].

    Science.gov (United States)

    Bauer, M; Scheithauer, S; Moerer, O; Pütz, H; Sliwa, B; Schmidt, C E; Russo, S G; Waeschle, R M

    2015-10-01

    The assurance of high standards of care is a major requirement in German hospitals while cost reduction and efficient use of resources are mandatory. These requirements are particularly evident in the high-risk and cost-intensive operating theatre field with multiple process steps. The cleaning of operating rooms (OR) between surgical procedures is of major relevance for patient safety and requires time and human resources. The hygiene procedure plan for OR cleaning between operations at the university hospital in Göttingen was revised and optimized according to the plan-do-check-act principle due to not clearly defined specifications of responsibilities, use of resources, prolonged process times and increased staff engagement. The current status was evaluated in 2012 as part of the first step "plan". The subsequent step "do" included an expert symposium with external consultants, interdisciplinary consensus conferences with an actualization of the former hygiene procedure plan and the implementation process. All staff members involved were integrated into this management change process. The penetration rate of the training and information measures as well as the acceptance and compliance with the new hygiene procedure plan were reviewed within step "check". The rates of positive swabs and air sampling as well as of postoperative wound infections were analyzed for quality control and no evidence for a reduced effectiveness of the new hygiene plan was found. After the successful implementation of these measures the next improvement cycle ("act") was performed in 2014 which led to a simplification of the hygiene plan by reduction of the number of defined cleaning and disinfection programs for preparation of the OR. The reorganization measures described led to a comprehensive commitment of the hygiene procedure plan by distinct specifications for responsibilities, for the course of action and for the use of resources. Furthermore, a simplification of the plan, a

  20. Interim results of the study of control room crew staffing for advanced passive reactor plants

    Energy Technology Data Exchange (ETDEWEB)

    Hallbert, B.P.; Sebok, A.; Haugset, K. [OECD Halden Reactor Project (Norway)

    1996-03-01

    Differences in the ways in which vendors expect the operations staff to interact with advanced passive plants by vendors have led to a need for reconsideration of the minimum shift staffing requirements of licensed Reactor Operators and Senior Reactor Operators contained in current federal regulations (i.e., 10 CFR 50.54(m)). A research project is being carried out to evaluate the impact(s) of advanced passive plant design and staffing of control room crews on operator and team performance. The purpose of the project is to contribute to the understanding of potential safety issues and provide data to support the development of design review guidance. Two factors are being evaluated across a range of plant operating conditions: control room crew staffing; and characteristics of the operating facility itself, whether it employs conventional or advanced, passive features. This paper presents the results of the first phase of the study conducted at the Loviisa nuclear power station earlier this year. Loviisa served as the conventional plant in this study. Data collection from four crews were collected from a series of design basis scenarios, each crew serving in either a normal or minimum staffing configuration. Results of data analyses show that crews participating in the minimum shift staffing configuration experienced significantly higher workload, had lower situation awareness, demonstrated significantly less effective team performance, and performed more poorly as a crew than the crews participating in the normal shift staffing configuration. The baseline data on crew configurations from the conventional plant setting will be compared with similar data to be collected from the advanced plant setting, and a report prepared providing the results of the entire study.

  1. Green monolithic II-VI vertical-cavity surface-emitting laser operating at room temperature

    Science.gov (United States)

    Kruse, C.; Ulrich, S. M.; Alexe, G.; Roventa, E.; Kröger, R.; Brendemühl, B.; Michler, P.; Gutowski, J.; Hommel, D.

    2004-02-01

    The realization of a monolithic all II-VI-based vertical cavity surface emitting laser (VCSEL) for the green spectral region is reported. Optically pumped lasing operation was achieved up to room temperature using a planar VCSEL structure. Taking advantage of distributed Bragg-reflectors based on MgS/Zn(Cd)Se superlattices as the low-refractive index material and ZnS0.06Se0.94 layers as the high-index material with a refractive index contrast of n = 0.6, a quality factor exceeding Q = 2000 is reached by using only 18 Bragg periods for the bottom DBR and 15 Bragg periods for the top DBR. The threshold power density is 0.32 MW/cm2 at a temperature of 10 K (emission wavelength 498.5 nm) and 1.9 MW/cm2 at room temperature (emission wavelength 502.3 nm).

  2. Tracheotomy in Pediatric Patients: In Operating Room or Intensive Care Unit?

    Directory of Open Access Journals (Sweden)

    Umut Kaygusuz

    2014-08-01

    Full Text Available Introduction: The morbidity and mortality rates of tracheotomy are higher in the pediatric population because the incision is small and the trachea is more prone to surgical trauma. Tracheotomy procedure is mostly performed in operating room in most institutions. The aim of the study is to compare the outcomes of tracheotomy procedures between intensive care unit (ICU and operating room (OR in terms of pitfalls, complications and family preferences. Materials and Methods: In between June 2012 and July 2013, at a single institution, 39 patients were prospectively analyzed for age, gender, primary pathology, tracheotomy indications, location of operation, the duration of family consent, perioperative complications and presence of decanulation. Results: Male/female ratio was 20/19. Mean age was 49.9±52.5 (4-204 months. Tracheotomy procedure was performed in OR in 19 patients (45% and in ICU in 20 (54.5% patients. There was no statistically significant difference between groups in terms of complications (OR-48.7%, ICU-51.3%. The time of informed consent was significantly shorter in ICU patients. Conclusions: There is no significant difference in terms of safety for tracheotomy procedure in ICU or OR. Parents give approval to a bedside invasive procedure faster. The words ‘Surgery’ and ‘Operating room’ can easily confuse the parents, extend the duration for endolaryngeal intubation, and increase the cost and labour loss.

  3. Dry lab practice leads to improved laparoscopic performance in the operating room.

    Science.gov (United States)

    Stelzer, Marie K; Abdel, Matthew P; Sloan, Michael P; Gould, Jon C

    2009-06-01

    Research has demonstrated that practice in surgical simulators leads to improved performance in that simulator. Our hypothesis is that skills acquired in simulators are transferable to the operating room. Twenty-three laparoscopically naïve surgical interns performed two standardized tasks in a simulator: pegboard transfer and intracorporeal knot tying. Performance was measured using a validated scoring system. On the same day as this initial assessment, subjects were videotaped performing two tasks in a live porcine model: running the small bowel and intracorporeal knot tying. Performance in the porcine model was measured using a modified version of a validated skills assessment tool by two blinded experts. Following a 6-wk proficiency-based dry lab laparoscopic training course, task performance was re-evaluated. No interval live operative laparoscopic experience occurred between the first and second assessment. After training, mean pegboard transfer scores increased from 118.7 to 181.8 (theoretical maximum = 300; P operative model. We believe that this is evidence that laparoscopic skills developed in a dry laboratory setting are transferable to the operating room.

  4. A survey of static and dynamic work postures of operating room staff.

    Science.gov (United States)

    Kant, I J; de Jong, L C; van Rijssen-Moll, M; Borm, P J

    1992-01-01

    Work in health care units is associated with considerable physical strain and many musculoskeletal complaints. Most investigations have concentrated on the work of general hospital nurses; little is known about the physical stress load on other health care workers. We therefore carried out an ergonomic study amongst operating room staff in order to (i) determine the work (posture) stress load on this particular group of health care workers and the effect of static posture on this stress, (ii) identify activities involving poor work postures, and (iii) determine differences between specialties in regard to work posture stress load. The work postures and related work activities of four different groups of staff in operating rooms (surgeons, assistant anaesthesists, instrumentation nurses and circulating nurses) were recorded and evaluated using the specified Ovako Working posture Analysing System (OWAS). Observation during the course of 18 daily surgical programmes (total number of observations: 3714) in the specialties general surgery and ear-nose-throat (ENT) surgery revealed that the work-load according to OWAS for circulating nurses and assistant anaesthesists was not harmful. Some work postures seen among instrumentation nurses and surgeons, however, need improvement. The work posture stress load in these groups is mainly due to the high prevalence of static work postures during the activities "surgery" (surgeons) and "assisting surgery" (instrumentation nurses). Significant differences in ergonomic stress load were observed between general surgeons and ENT surgeons. This survey in operating theatres relates work postures to basic activities and can be used as a starting point from which to improve work conditions in order to reduce or eliminate physical complaints among operating room staff.

  5. 浅谈手术室的整体护理%Operating Room Holistic Nursing

    Institute of Scientific and Technical Information of China (English)

    王丽娜

    2015-01-01

    This paper discusses the operation room nursing work not only with technical operation, simple operation, should also pay attention to humanistic care operation patients. Master the communication skills. In the process of nursing operation should take the patient as the center to respect the rights of people to serve patients. Caring patients is all care as the starting point and destination, to realize the whole process of operation of holistic nursing. The effective implementation of holistic nursing operation room will improve patient's satisfaction to our work to change from passive to active nursing care.%本文论述了手术室的护理工作不能仅限于配合手术等单纯的技术操作,也应该注重手术患者的人文关怀,掌握沟通技巧。在进行各项护理操作过程中,都要以患者为中心开展,尊重患者的权利,服务于患者。把对患者的关怀作为一切护理工作的出发点和归宿,真正实现手术全过程整体化护理。手术室整体护理模式的有效实施将会提高患者就医满意度,把我们的工作由被动护理转变为主动护理。

  6. Factors predicting the increased risk for return to the operating room in bariatric patients: a NSQIP database study.

    Science.gov (United States)

    Nandipati, Kalyana; Lin, Edward; Husain, Farah; Perez, Sebastian; Srinivasan, Jahnavi; Sweeney, John F; Davis, S Scott

    2013-04-01

    The objective of the study was to assess the risk factors associated with return to the operating room in bariatric surgery patients. Using the American College of Surgeons-National Surgical Quality Improvement Project's participant-use file, patients who underwent laparoscopic gastric bypass (LRYGB) and adjustable gastric band (LAGB) procedures for morbid obesity were identified. Several pre-, peri-, and postoperative variables, including 30 day morbidity and mortality, were collected. The study population was divided into two groups: patients returning to the operating room (group 1), and patients not returning to the operating room (group 2). Variables analyzed included postoperative complications, overall morbidity, and mortality. Relationships between preoperative and perioperative factors leading to the return to the operating room also were analyzed. Of 28,241 (LRYGB = 18,671, LAGB = 9,570) patients included in the study, 644 (2.3 %) patients returned to the operating room. Of the study population, 30 day mortality rate was 0.13 % (37/28,241) and morbidity was 4.1 % (1,155/28,241). Patients returning to the operating room had a higher mortality [14/644 (2.2 %) vs. 23/27,597 (0.01 %); P return to the operating room. Postoperative complications (superficial wound infection, deep surgical site infection, organ space infection, pneumonia, pulmonary embolism, renal insufficiency, renal failure, septic shock, and length of stay) were significantly higher for patients who required reoperation. On multivariate logistic regression analysis, the bypass operation, bleeding disorder, patients on dialysis, preoperative hematocrit, preoperative low albumin, and length of operation were associated with increased risk of return to the operating room. In the bariatric population, return to the operating room is associated with significantly higher morbidity and mortality. Patients who are on dialysis, have a low preoperative serum albumin, and a history of bleeding disorders

  7. A study on scattered dose in operation room by C-arm unit

    Energy Technology Data Exchange (ETDEWEB)

    An, Sung Min; Oh, Jung Hwan; Kim, Sung Chul [Gachon Gil College, Incheon (Korea, Republic of)

    2000-04-15

    This paper studied a C-arm's exposure condition and measured scatter rays by thickness and distance. This study reached the following conclusion. Approximately exposure dose for a patient using fluoroscopy is as follows: Mostly, an operating room was not shielding by lead and operator put on only apron without thyroid and facial part protection. 0.5 mmPb equivalent's apron shielded about 99% of scattered rays at 60 cm from x-ray tube. Scattered rays are depended on distance and thickness so operators are should be careful when using fluoroscopy by C-arm and if possible use high frequency equipment that has a large output.

  8. Low frequency sound field control in rectangular listening rooms using CABS (Controlled Acoustic Bass System) will also reduce sound transmission to neighbor rooms

    DEFF Research Database (Denmark)

    Nielsen, Sofus Birkedal; Celestinos, Adrian

    2011-01-01

    from the rear wall, and thereby leaving only the plane wave in the room. With a room size of (7.8 x 4.1 x 2.8) m. it is possible to prevent modal frequencies up to 100 Hz. An investigation has shown that the sound transmitted to a neighbour room also will be reduced if CABS is used. The principle......Sound reproduction is often taking place in small and medium sized rectangular rooms. As rectangular rooms have 3 pairs of parallel walls the reflections at especially low frequencies will cause up to 30 dB spatial variations of the sound pressure level in the room. This will take place not only...... at resonance frequencies, but more or less at all frequencies. A time based room correction system named CABS (Controlled Acoustic Bass System) has been developed and is able to create a homogeneous sound field in the whole room at low frequencies by proper placement of multiple loudspeakers. A normal setup...

  9. Forced-air warming: a source of airborne contamination in the operating room?

    Directory of Open Access Journals (Sweden)

    David Leaper

    2009-12-01

    Full Text Available Forced-air-warming (FAW is an effective and widely used means for maintaining surgical normothermia, but FAW also has the potential to generate and mobilize airborne contamination in the operating room. We measured the emission of viable and non-viable forms of airborne contamination from an arbitrary selection of FAW blowers (n=25 in the operating room. A laser particle counter measured particulate concentrations of the air near the intake filter and in the distal hose airstream. Filtration efficiency was calculated as the reduction in particulate concentration in the distal hose airstream relative to that of the intake. Microbial colonization of the FAW blower’s internal hose surfaces was assessed by culturing the microorganisms recovered through swabbing (n=17 and rinsing (n=9 techniques. Particle counting revealed that 24% of FAW blowers were emitting significant levels of internally generated airborne contamination in the 0.5 to 5.0 mm size range, evidenced by a steep decrease in FAW blower filtration efficiency for particles 0.5 to 5.0 mm in size. The particle size-range-specific reduction in efficiency could not be explained by the filtration properties of the intake filter. Instead, the reduction was found to be caused by size-range-specific particle generation within the FAW blowers. Microorganisms were detected on the internal air path surfaces of 94% of FAW blowers. The design of FAW blowers was found to be questionable for preventing the build-up of internal contamination and the emission of airborne contamination into the operating room. Although we did not evaluate the link between FAW and surgical site infection rates, a significant percentage of FAW blowers with positive microbial cultures were emitting internally generated airborne contamination within the size range of free floating bacteria and fungi (<4 mm that could, conceivably, settle onto the surgical site.

  10. The operating room case-mix problem under uncertainty and nurses capacity constraints.

    Science.gov (United States)

    Yahia, Zakaria; Eltawil, Amr B; Harraz, Nermine A

    2016-12-01

    Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied. The proposed model is used to determine the number of surgery cases to be weekly served, the amount of operating rooms' time dedicated to each specialty and the number of ward beds dedicated to each specialty. The optimal case-mix selection criterion is based upon a weighted score taking into account both the waiting list and the historical demand of each patient category. The score aims to maximizing the service level of the operating rooms by increasing the total number of surgery cases that could be served. A computational experiment is presented to demonstrate the performance of the proposed method. The results show that the stochastic model solution outperforms the expected value problem solution. Additional analysis is conducted to study the effect of varying the number of ORs and nurses capacity on the overall ORs' performance.

  11. Teaching techniques in the operating room: the importance of perceptual motor teaching.

    Science.gov (United States)

    Skoczylas, Laura C; Littleton, Eliza B; Kanter, Steven L; Sutkin, Gary

    2012-03-01

    To identify sucessful teaching techniques in the operating room environment through examining the teaching of the midurethral sling (MUS) surgery. The authors distributed questionnaires with open-ended questions about teaching and learning MUS to 5 urogynecology attendings and 16 obstetrics-gynecology residents in spring 2010. In an effort to identify qualities of an effective sling teacher, the authors used grounded theory to determine common themes and to code participant responses for examples. Of 21 potential respondents, 14 (67%) returned questionnaires. The authors analyzed these and identified seven commonalities among effective sling teachers: they (1) emphasize anatomical landmarks (as determined by 64 total comments); (2) use perceptual-motor teaching (PMT; 38 comments); (3) encourage repetition (28); (4) promote early independence (34); (5) demonstrate confident competence (23); (6) maintain a calm demeanor in the operating room (20); and (7) exhibit a willingness to accept responsibility for mistakes and consequences (9). The second-most common attribute, using PMT, requires the teaching attending to emphasize the motor and tactile aspects of operating and involves incorporating not only what learners see but also what they feel. The authors report seven qualities or techniques fundamental to good teaching practice in a high-stress, high-technology surgical environment, and they have identified the use of PMT, which to their knowledge has not been previously described. Teachers and learners in this study characterized PMT, which is likely generalizable to surgical procedures other than the MUS, as important. Future research should focus on exploring this technique in other surgeries.

  12. Don't break the chain: importance of supply chain management in the operating room setting.

    Science.gov (United States)

    Bilyk, Candis

    2008-09-01

    Management of supplies within the operating room (OR) has considerable implications for decreasing healthcare costs while maintaining high-quality patient care. This area of healthcare therefore requires more monitoring by end-users including OR management, physicians, and nursing staff. This article is based on understanding supply chain management in the OR setting. Information provided throughout the article can be applied to small or large health care centers. It defines supply chain management and contains a brief overview of supply chain processes. It reviews the benefits of following these processes. The article also includes recommendations for improving the supply chain in the OR.

  13. Application of Time Management in Operation Room Nursing%时间管理在手术室护理管理中的应用

    Institute of Scientific and Technical Information of China (English)

    王光明; 陈佐彩

    2015-01-01

    目的:探讨时间管理对提高手术室工作效率的效果。方法我院2013年制定并实施手术室时间管理,通过成立质量管理小组、建立手术室时间质量管理制度、严格控制第一台手术开台时间、缩短手术室台间间隔时间、节假日适当安排择期手术等方式方法,提高手术室工作效率。结果2013年共实施手术2469台,日均手术6.8台,第一台手术准时开台率达83%,高于2012年的27%。2013年各科室人员对手术室护理工作满意度明显提高。结论在手术室实施时间管理,可有效提升手术室工作效率、医护人员工作满意度,而且提高了医院经济效益。%Objective To investigate the effect of time management to improve the work efifciency of the operation room.MethodsIn our hospital in 2013 to develop and implement operation room, time management, through the establishment of quality management team, the establishment of operation room time quality management system, strictly control the ifrst surgery founding time, shorten the operation room table time interval, holidays elective surgery way methods appropriate to improve the working efifciency of the operation room.Results A total of 2469 units in 2013 to implement the operation, the daily operation of 6.8 units. In 2013 the ifrst operation time of founding rate of 83%, higher than the 27% in 2012.In 2013 the Department staff on operation room nursing satisfaction improved signiifcantly.ConclusionThe implementation of time management in the operation room, operation room can effectively improve work efifciency, job satisfaction of medical staff, and improve the economic benefit of hospital.

  14. Are the urology operating room personnel aware about the ionizing radiation?

    Directory of Open Access Journals (Sweden)

    Adem Tok

    2015-10-01

    Full Text Available ABSTRACT Purpose: We assessed and evaluated attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Materials and Methods: A questionnaire was sent by e-mail to urology surgery room personnel in Turkey, between June and August 2013. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results: In total, 127 questionnaires were answered. Of them, 62 (48.8% were nurses, 51 (40.2% were other personnel, and 14 (11% were radiological technicians. In total, 113 (89% participants had some knowledge of radiation, but only 56 (44.1% had received specific education or training regarding the harmful effects of radiation. In total, 92 (72.4% participants indicated that they used a lead apron and a thyroid shield. In the subgroup that had received education about the harmful effects of radiation, the use ratio for all protective procedures was 21.4% (n=12; this ratio was only 2.8% (n=2 for those with no specific training; the difference was statistically significant (p=0.004. Regarding dosimeters, the use rates were 100% for radiology technicians, 46.8% for nurses, and 31.4% for other hospital personnel; these differences were statistically significant (p<0.001. No significant relationship between working period in the surgery room, number of daily fluoroscopy procedures, education, task, and use of radiation protection measures was found. Conclusions: It is clear that operating room-allied health personnel exposed to radiation do not have sufficient knowledge of ionizing radiation and they do not take sufficient protective measures.

  15. Simulated versus realistic intra operative radiation therapy (I.O.R.T.) treatment in operating room: from knowledge of stray radiation to action

    Energy Technology Data Exchange (ETDEWEB)

    Andreoli, S.; Moretti, R. [USC Fisica Sanitaria - Ospedali Riuniti di Bergamo (Italy); Catalano, M.; Locatelli, F. [Degli Studi di Milano Univ., Scuola di Specializzazione in Fisica Sanitaria (Italy)

    2006-07-01

    Intra-Operative Radiation Therapy (I.O.R.T.) is carried out with electron beams produced by a Linac (Linear Accelerator) generally used for conventional radiotherapy with external beam, or by dedicated accelerators that can be employed directly into an operating room. I.O.R.T. refers to the application of radiation during a surgical intervention, after the removal of a neoplastic mass. I.O.R.T. uses on the tumour area a direct irradiation, for the possible localisation of sub-clinic illness or macroscopic residue in the case of non-radical resection. Intra-Operative Radiotherapy foresees a single session only, generally preceded or followed by radiotherapy with external beam. It allows the achievement of a selective radiation boost on the tumour volume. In some cases, it can also be used as a one-time/stand alone treatment in initial cancer of small volume, or in unresectable malignancies for palliative purpose. The technical advantages of I.O.R.T. consist in the direct visual control of the target volume, and in the possibility to protect the healthy tissues by moving them away from the path of the radiation beam. The use of electron beams allows the administration of a homogeneous dose to a selected layer of tissues surrounding the tumour. The following professional staff forms the Operative Group: radiation oncologist, surgeon, anaesthetist, medical physicist, radiation technologist, nurse.The choice of a simulation geometry very similar to the clinical situation allows to evaluate radioprotection data very close to the real situation. For a fixed layout, an anthropomorphic phantom was positioned on the operating bed and a breast I.O.R.T. treatment was simulated positioning all the accessories of the operating room in their typical positions. A detailed dose mapping was performed with a Victoreen 450P ionisation chamber and with environment film-dosimeter on the walls of the operating room during the simulation of the clinical treatment. The simulation appears

  16. Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

    Science.gov (United States)

    Tang, Chin-Sheng; Wan, Gwo-Hwa

    2013-01-01

    To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

  17. Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chin-Sheng Tang

    Full Text Available To prevent surgical site infection (SSI, the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH, and carbon dioxide (CO2, suspended particulate matter (PM, and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18% and traumatic surgery room (8%. The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

  18. Air Quality Monitoring of the Post-Operative Recovery Room and Locations Surrounding Operating Theaters in a Medical Center in Taiwan

    Science.gov (United States)

    Tang, Chin-Sheng; Wan, Gwo-Hwa

    2013-01-01

    To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers. PMID:23573296

  19. Effect analysis of quality control circle activity improving hand-washing compliance of circulating nurses in operating room%品管圈活动对提高手术室巡回护士洗手依从性效果分析

    Institute of Scientific and Technical Information of China (English)

    万美萍; 吴明琴; 罗媛榕

    2015-01-01

    目的:分析影响护理人员手卫生执行的相关因素,探究品管圈活动对于提高手术室巡回护士洗手依从性及综合素质的效果。方法选取我院12名手术室巡回护士为研究对象,采用品管圈的管理方式对其进行护理干预,比较不同时段内护理人员的洗手依从性及综合素质。结果干预实施前及干预1周后、干预2周后巡回护士的总体洗手执行率分别为72%、80.0%、73.3%,总体洗手执行率在干预1周后显著上升。2周后又回落到了干预前相似水平,干预实施前及干预1周后、干预2周后巡回护士的平均素质得分分别为(52.4±4.6)、(68.0±6.4)、(83.6±8.5),差异均有统计学意义(P<0.01)。结论品管圈活动可以有效提高手术室巡回护士的综合素质,在短期内也可迅速提升其洗手的依从性,但由于品管圈活动缺乏长期监督管理的环境,巡回护士其交接安置患者洗手率会严重回落,直接导致总体洗手依从性会再次回落。%ObjectiveTo analyze related factors of hand hygiene implementation and to explore effect of quality control circle activity on improving hand-washing compliance and comprehensive quality of circulating nurses in operating room.Methods12 circulating nurses of operating room in our hospital were selected as research objects and they were received nursing intervention by management method of quality control circle. Hand-washing compliance and comprehensive quality of nursing staff during different periods were compared.Results Total hand-washing implementation rates before intervention, 1 week after intervention and 2 weeks after intervention of circulating nurses were 72%, 80.0% and 73.3% respectively. Total hand-washing implementation rate of 1 week after intervention was significantly increased while total hand-washing implementation rate of weeks after intervention was the same as that before intervention. Average quality

  20. A professional and cost effective digital video editing and image storage system for the operating room.

    Science.gov (United States)

    Scollato, A; Perrini, P; Benedetto, N; Di Lorenzo, N

    2007-06-01

    We propose an easy-to-construct digital video editing system ideal to produce video documentation and still images. A digital video editing system applicable to many video sources in the operating room is described in detail. The proposed system has proved easy to use and permits one to obtain videography quickly and easily. Mixing different streams of video input from all the devices in use in the operating room, the application of filters and effects produces a final, professional end-product. Recording on a DVD provides an inexpensive, portable and easy-to-use medium to store or re-edit or tape at a later time. From stored videography it is easy to extract high-quality, still images useful for teaching, presentations and publications. In conclusion digital videography and still photography can easily be recorded by the proposed system, producing high-quality video recording. The use of firewire ports provides good compatibility with next-generation hardware and software. The high standard of quality makes the proposed system one of the lowest priced products available today.

  1. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel.

    Science.gov (United States)

    Okoshi, Kae; Kobayashi, Katsutoshi; Kinoshita, Koichi; Tomizawa, Yasuko; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-08-01

    Although surgical smoke contains potentially hazardous substances, such as cellular material, blood fragments, microorganisms, toxic gases and vapors, many operating rooms (ORs) do not provide protection from exposure to it. This article reviews the hazards of surgical smoke and the means of protecting OR personnel. Our objectives are to promote surgeons' acceptance to adopt measures to minimize the hazards. Depending on its components, surgical smoke can increase the risk of acute and chronic pulmonary conditions, cause acute headaches; irritation and soreness of the eyes, nose and throat; dermatitis and colic. Transmission of infectious disease may occur if bacterial or viral fragments present in the smoke are inhaled. The presence of carcinogens in surgical smoke and their mutagenic effects are also of concern. This review summarizes previously published reports and data regarding the toxic components of surgical smoke, the possible adverse effects on the health of operating room personnel and measures that can be used to minimize exposure to prevent respiratory problems. To reduce the hazards, surgical smoke should be removed by an evacuation system. Surgeons should assess the potential dangers of surgical smoke and encourage the use of evacuation devices to minimize potential health hazards to both themselves and other OR personnel.

  2. Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.

    Science.gov (United States)

    Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F

    2016-08-05

    We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, pteamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.

  3. Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology.

    Science.gov (United States)

    Tagge, Edward P; Thirumoorthi, Arul S; Lenart, John; Garberoglio, Carlos; Mitchell, Kenneth W

    2017-06-01

    Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41min in the baseline period to 32min in the intervention period (p<0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5min in the baseline period to 71min in the intervention period (p<0.0001). These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Prospective comparative study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Room-temperature operation of a titanium supersaturated silicon-based infrared photodetector

    Science.gov (United States)

    García-Hemme, E.; García-Hernansanz, R.; Olea, J.; Pastor, D.; del Prado, A.; Mártil, I.; González-Díaz, G.

    2014-05-01

    We report room-temperature operation of 1 × 1 cm2 infrared photoconductive photodetectors based on silicon supersaturated with titanium. We have fabricated these Si-based infrared photodetectors devices by means of ion implantation followed by a pulsed laser melting process. A high sub-band gap responsivity of 34 mV W-1 has been obtained operating at the useful telecommunication applications wavelength of 1.55 μm (0.8 eV). The sub-band gap responsivity shows a cut-off frequency as high as 1.9 kHz. These Si-based devices exhibit a non-previous reported specific detectivity of 1.7 × 104 cm Hz1/2 W-1 at 660 Hz, under a 1.55 μm wavelength light. This work shows the potential of Ti supersaturated Si as a fully CMOS-compatible material for the infrared photodetection technology.

  5. [The application of operating room quality backward system in instrument place management].

    Science.gov (United States)

    Du, Hui; He, Anjie; Zeng, Leilei

    2010-09-01

    Improvement of the surgery instrument's clean quality, the optimized preparation way, reasonable arrangement in groups, raising the working efficiency. We use the quality backward system into the instrument clean, the pack and the preparation way's question, carry on the analysis and the optimization, and appraise the effect after trying out 6 months. After finally the way optimized, instrument clean quality distinct enhancement; The flaws in the instrument clean, the pack way and the total operating time reduce; the contradictory between nurses and the cleans arising from the unclear connection reduces, the satisfaction degree of nurse and doctor to the instrument enhances. Using of operating room quality backward system in the management of the instrument clean, the pack and the preparation way optimized, may reduce flaws in the work and the waste of human resources, raise the working efficiency.

  6. Demonstration of Intelligent Control and Fan Improvements in Computer Room Air Handlers

    Energy Technology Data Exchange (ETDEWEB)

    Coles, Henry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Greenberg, Steve [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Vita, Corinne [Vigilent, Oakland, CA (United States)

    2012-11-30

    This report documents a demonstration of the energy-efficiency improvement provided by a new control system for computer room air handling devices. It also analyzes measured and reported air handling device fan power associated with changing the fan type. A 135,000 square foot commercial data center was used for the demonstration. All air handling units were upgraded with improved efficiency fans, and a control system that automatically adjusts the fan speed for the air handling units was added. Power measurements were collected for a baseline and for a period with the fan speed control system active. Changing the fan type resulted in a savings of 47 percent of energy used by the air handling equipment and associated chiller plant energy needed to cool the air handlers themselves. The addition of the fan speed control resulted in an additional 37 percent savings in the same two categories. The combined savings for the two improvements for the same categories was 66 percent compared to the data center fitted with the original fans without a control system. The energy use reduction provided by the complete air handling device improvement program for the whole data center site is estimated to be 2.9 million kilowatt hours per year—an overall data center site savings of 8.0 percent. The reduced electrical energy use at the site provides a 1.9 million pound yearly reduction of carbon dioxide emissions. This demonstration showed that fan upgrades and a control system addition provide cost-effective improvements for data centers, with a payback reported to be under two years without utility incentives. In addition to the control system providing energy savings, the data collection and visual analysis capabilities provided immediate and long-term benefits. It is recommended that data center operators consider investing in fan upgrades and/or adding fan speed control for computer room air handlers.

  7. Room-temperature triggered single photon emission from a III-nitride site-controlled nanowire quantum dot.

    Science.gov (United States)

    Holmes, Mark J; Choi, Kihyun; Kako, Satoshi; Arita, Munetaka; Arakawa, Yasuhiko

    2014-02-12

    We demonstrate triggered single photon emission at room temperature from a site-controlled III-nitride quantum dot embedded in a nanowire. Moreover, we reveal a remarkable temperature insensitivity of the single photon statistics, and a g((2))[0] value at 300 K of just 0.13. The combination of using high-quality, small, site-controlled quantum dots with a wide-bandgap material system is crucial for providing both sufficient exciton confinement and an emission spectrum with minimal contamination in order to enable room temperature operation. Arrays of such single photon emitters will be useful for room-temperature quantum information processing applications such as on-chip quantum communication.

  8. An Investigation on the Current Status of the Operation Recovery Rooms in Yazd Hospitals in 2010-2011

    Directory of Open Access Journals (Sweden)

    MR Khajeh Aminian

    2012-08-01

    Full Text Available Introduction: The recovery ward is a vital unit to care patients awaking from anesthesia and is a standard requirement for the operating room. Recovery ward is located adjacent to the operation room and is easily accessible to trained and skilled individuals. The unit must have adequate equipment for surveillance and monitoring of patients and required medication should also be provided. Methods: This study is a cross-sectional conducted in one phase through referring to hospital facilities and equipment. Physical space, personnel and their skill levels and other factors that are involved in the care of patients in the recovery have been investigated. The instruments used in this study were a check list and observe sheet which were completed by the researchers. Data analysis was conducted by SPSS software. Results: The results showed that the standards of buildings and physical space in the researched areas were mostly nonstandard. Equipment standards were to some extent in line with the criteria set by American Association of Anesthesia. Besides, some equipment was blow standard levels. Personnel standards regarding the number of nurses toward the number of recovery beds did not meet the standard criteria in most of the cases. Conclusion: The research shows that building standards in most cases are not in line with mentioned references. Undertaking equipment standards in the hospital recovery wards needs reviewing and providing controlling equipment for preventing the complications of recovery phase of anesthesia in recovery wards.

  9. Which algorithm for scheduling add-on elective cases maximizes operating room utilization? Use of bin packing algorithms and fuzzy constraints in operating room management.

    Science.gov (United States)

    Dexter, F; Macario, A; Traub, R D

    1999-11-01

    The algorithm to schedule add-on elective cases that maximizes operating room (OR) suite utilization is unknown. The goal of this study was to use computer simulation to evaluate 10 scheduling algorithms described in the management sciences literature to determine their relative performance at scheduling as many hours of add-on elective cases as possible into open OR time. From a surgical services information system for two separate surgical suites, the authors collected these data: (1) hours of open OR time available for add-on cases in each OR each day and (2) duration of each add-on case. These empirical data were used in computer simulations of case scheduling to compare algorithms appropriate for "variable-sized bin packing with bounded space." "Variable size" refers to differing amounts of open time in each "bin," or OR. The end point of the simulations was OR utilization (time an OR was used divided by the time the OR was available). Each day there were 0.24 +/- 0.11 and 0.28 +/- 0.23 simulated cases (mean +/- SD) scheduled to each OR in each of the two surgical suites. The algorithm that maximized OR utilization, Best Fit Descending with fuzzy constraints, achieved OR utilizations 4% larger than the algorithm with poorest performance. We identified the algorithm for scheduling add-on elective cases that maximizes OR utilization for surgical suites that usually have zero or one add-on elective case in each OR. The ease of implementation of the algorithm, either manually or in an OR information system, needs to be studied.

  10. Control console of the gamma calibration room; Consola de control de la Sala de Calibracion Gamma

    Energy Technology Data Exchange (ETDEWEB)

    Vilchis P, A.E.; Romero G, M. [Instituto Nacional de Investigaciones Nucleares, Ingenieria Electronica, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    1999-07-01

    The Nuclear Centre of Mexico has a Ionizing Radiation Metrology Center (CMRI). This is in charge of the calibration in Mexico and Latin America of equipment dedicated to radiation measurement as industrial, medical as other fields. The importance to ensure that the equipment stay justly calibrated, it is imposed the necessity of automating the different rooms which the CMRI has. in this case it will be exposed the Calibration room for gamma radiation type. The operation of this application was carried out with the LabVIEW development platform and also in C language. The hardware associated is: personal computer with two cards using the 8255 device, 16 channels with optical isolation to manage input/output TTL type, 16 channels with optical isolation to management of charges to 127 V a.c., and 2 channels for 90V d.c. motors. (Author)

  11. Virtual Visit to the ATLAS Control Room by Institute of Nuclear Physics, Cracow, Poland

    CERN Multimedia

    ATLAS Experiment

    2012-01-01

    The 12 Festival of Science "Theory-knowledge-experience...". Fest will be located on the traditional Main Square, which is visited by thousands of citizens and tourists. Institute of Nuclear Physics as usual participates in this annual event. Our visitors will learn the secrets of the CERN experiments on the Large Hadron Collider - ATLAS, LHCb, ALICE, CMS, find out more about the Higgs particles, antimatter quark-gluon plasma (beeing guided by our scientists and PhD students). One of the attractions will be ATLAS Control Room Virtual Visit. Visiting people will have an opportunity to see how ATLAS is controlled and operated to collect its exciting data and ask questions to scientists and engineers involved in LHC program at CERN. Institute of Nuclear Physics has prepared also several interactive demonstrations of Atomic Force Microscopy, Magnetic Resonance, Hadron Therapy and Crystal Physics. The Institute of Nuclear Physics of the Polish Academy of Sciences carries out basic and applied research in physics, ...

  12. Deployment of a Full-Scope Commercial Nuclear Power Plant Control Room Simulator at the Idaho National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Ronald Boring; Julius Persensky; Kenneth Thomas

    2011-09-01

    The INL operates the HSSL to conduct research in the design and evaluation of advanced reactor control rooms, integration of intelligent support systems to assist operators, development and assessment of advanced human performance models, and visualizations to assess advanced operational concepts across various infrastructures. This advanced facility consists of a reconfigurable simulator and a virtual reality capability (known as the Computer-Aided Virtual Environment (CAVE)) (Figure 2). It supports human factors research, including human-in-the-loop performance, HSI, and analog and digital hybrid control displays. It can be applied to the development and evaluation of control systems and displays for complex systems such as existing and advanced NPP control rooms, command and control systems, and advance emergency operations centers. The HSSL incorporates a reconfigurable control room simulator, which is currently housed in the Center for Advanced Energy Studies (CAES), a joint venture of the DOE and the Idaho University System. The simulator is a platform- and plant-neutral environment intended for full-scope and part-task testing of operator performance in various control room configurations. The simulator is not limited to a particular plant or even simulator architecture. It can support engineering simulator platforms from multiple vendors using digital interfaces. Due to its ability to be reconfigured, it is possible to switch the HSI - not just to digital panels but also to different control modalities such as those using greater plant automation or intelligent alarm filtering. The simulator currently includes three operator workstations, each capable of driving up to eight 30-inch monitors. The size and number of monitors varies depending on the particular front-end simulator deployed for a simulator study. These operator workstations would typically be used for the shift supervisor or senior reactor operator, reactor operator, and assistant reactor

  13. Operating Room Efficiency: Benefits of an Orthopaedic Traumatologist at a Level II Trauma Center.

    Science.gov (United States)

    Althausen, Peter L; Kauk, Justin R; Shannon, Steven; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

    2016-12-01

    Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. Retrospective review. Level II community-based trauma hospital. Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1, 2010, to December 31, 2011. Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and nontrauma fellowship-trained orthopaedic surgeons. Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's 3 traumatologists and those treated by the 15 GOSs on our trauma panel. These 2 groups were then compared using standard statistical methods. A total of 6449 orthopedic cases were identified and 2076 of these involved fracture care. One thousand one hundred ninety-nine patients were treated by traumatologists and 877 by GOSs. There was no statistical difference detected in American Society of Anesthesiologists score between trauma and nontrauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compared with the GOS group (55.6 vs. 75.8 minutes, P , 0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs ($381.4 vs. $484.8; P Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  14. The evolution of a purpose designed hybrid trauma operating room from the trauma service perspective: the RAPTOR (Resuscitation with Angiography Percutaneous Treatments and Operative Resuscitations).

    Science.gov (United States)

    Kirkpatrick, Andrew W; Vis, Christine; Dubé, Mirette; Biesbroek, Susan; Ball, Chad G; Laberge, Jason; Shultz, Jonas; Rea, Ken; Sadler, David; Holcomb, John B; Kortbeek, John

    2014-09-01

    Traumatic injury is the leading cause of potentially preventable lost years of life in the Western world and exsanguination is the most potentially preventable cause of post-traumatic death. With mature trauma systems and experienced trauma centres, extra-abdominal sites, such as the pelvis, constitute the most frequent anatomic site of exsanguination. Haemorrhage control for such bleeding often requires surgical adjuncts most notably interventional radiology (IR). With the usual paradigm of surgery conducted within an operating room and IR procedures within distant angiography suites, responsible clinicians are faced with making difficult decisions regarding where to transport the most physiologically unstable patients for haemorrhage control. If such a critical patient is transported to the wrong suite, they may die unnecessarily despite having potentially salvageable injuries. Thus, it seems only logical that the resuscitative operating room of the future would have IR capabilities making it the obvious geographic destination for critically unstable patients, especially those who are exsanguinating. Our trauma programme recently had the opportunity to conceive, design, build, and operationalise a purpose-designed hybrid trauma operating room, designated as the resuscitation with angiographic percutaneous techniques and operative resuscitation (RAPTOR) suite, which we believe to be the first such resource designed primarily to serve the exsanguinating trauma patient. The project was initiated after consultations between the trauma programme and private philanthropists regarding the greatest potential impacts on regional trauma care. The initial capital construction costs were thus privately generated but coincided with a new hospital wing construction allowing the RAPTOR to be purpose-designed for the exsanguinating patient. Many trauma programmes around the world are now starting to navigate the complex process of building new facilities, or else retrofitting

  15. Advantages and Disadvantages of Physiological Assessment For Next Generation Control Room Design

    Energy Technology Data Exchange (ETDEWEB)

    Tuan Q. Tran; Ronald L. Boring; Donald D. Dudenhoeffer; Bruce P Hallbert; M. David Keller; Tessa M. Anderson

    2007-08-01

    Abstract - We propose using non-obtrusive physiological assessment (e.g., eye tracking,) to assess human information processing errors (e.g., loss of vigilance) and limitations (e.g., workload) for advanced energy systems early in the design process. This physiological approach for assessing risk will circumvent many limitations of current risk methodologies such as subjective rating (e.g., rater’s biases) and performance modeling (e.g., risk assessment is scripted and is based upon the individual modeler’s judgment). Key uses will be to evaluate (early in the design process) novel control room equipment and configurations as well as newly developed automated systems that will inevitably place a high information load on operators. The physiological risk assessment tool will allow better precision in pinpointing problematic design issues and will provide a “real-time” assessment of risk. Furthermore, this physiological approach would extend the state-of-the-art of human reliability methods from a “static” measure to more “dynamic.” This paper will discuss a broad range of the current popular online performance gauges as well as its advantages and disadvantages for use in next generation control room.

  16. 49 CFR 236.777 - Operator, control.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Operator, control. 236.777 Section 236.777..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.777 Operator, control. An employee assigned to operate the control machine of a traffic control system....

  17. Modeling Human Error Mechanism for Soft Control in Advanced Control Rooms (ACRs)

    Energy Technology Data Exchange (ETDEWEB)

    Aljneibi, Hanan Salah Ali [Khalifa Univ., Abu Dhabi (United Arab Emirates); Ha, Jun Su; Kang, Seongkeun; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2015-10-15

    To achieve the switch from conventional analog-based design to digital design in ACRs, a large number of manual operating controls and switches have to be replaced by a few common multi-function devices which is called soft control system. The soft controls in APR-1400 ACRs are classified into safety-grade and non-safety-grade soft controls; each was designed using different and independent input devices in ACRs. The operations using soft controls require operators to perform new tasks which were not necessary in conventional controls such as navigating computerized displays to monitor plant information and control devices. These kinds of computerized displays and soft controls may make operations more convenient but they might cause new types of human error. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or human errors) during NPP operation. The developed model would contribute to a lot of applications to improve human performance (or reduce human errors), HMI designs, and operators' training program in ACRs. The developed model of human error mechanism for the soft control is based on assumptions that a human operator has certain amount of capacity in cognitive resources and if resources required by operating tasks are greater than resources invested by the operator, human error (or poor human performance) is likely to occur (especially in 'slip'); good HMI (Human-machine Interface) design decreases the required resources; operator's skillfulness decreases the required resources; and high vigilance increases the invested resources. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or reduction of human errors) during NPP operation.

  18. InSb Mid-Infrared Photon Detector for Room-Temperature Operation

    Science.gov (United States)

    Ueno, Koichiro; Gomes Camargo, Edson; Katsumata, Takashi; Goto, Hiromasa; Kuze, Naohiro; Kangawa, Yoshihiro; Kakimoto, Koichi

    2013-09-01

    We developed a small InSb mid-infrared (2-7 µm wavelength range) photon detector that operates at room temperature. The photodiode was made from (hetero epitaxial) InSb layers that were grown on a semi-insulating GaAs substrate by molecular beam epitaxy. To suppress the effects of the diffusion current of the p-i-n photodiode, we used an AlInSb barrier layer that raises the resistance of the photodiode. We also optimized the device's doping concentration and the infrared incidence window structure. These optimization steps realized high photoelectric current output in a room-temperature environment. We also increased the signal-to-noise ratio of the detector by connecting multiple photodiodes in series. The size of this detector is 1.9×2.7×0.4 mm3 and the detectivity is 2.8×108 cm Hz1/2/W at 300 K. This is a practical IR detector that can be used in general signal amplification ICs.

  19. Nitrous Oxide Levels In Operating and Recovery Rooms of Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Sh Sadigh Maroufi

    2011-06-01

    Full Text Available "nBackground: Nitrous oxide (N2O is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences."nMethods: During a 6-month period, we have measured the shift-long time weighted average concentration of N2O in 43 op­erating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences."nResults: The results show that the level of nitrous oxide in all hospitals is higher than the limits set by different countries and anesthetists are at higher risk of exposure. In addition, it was shown that installation of air ventilation could reduce not only the overall exposure level, but also the level of exposure of anesthetists in comparison with other personnel."nConclusion: The high nitrous oxide level in Iranian hospitals necessitates improvement of waste gas evacuation systems and regular monitoring to bring the concentration of this gas into the safe level.

  20. Surgical teams: role perspectives and role dynamics in the operating room.

    Science.gov (United States)

    Leach, Linda Searle; Myrtle, Robert C; Weaver, Fred A

    2011-05-01

    Observations of surgical teams in the operating room (OR) and interviews with surgeons, circulating registered nurses (RNs), anaesthesiologists and surgical technicians reveal the importance of leadership, team member competencies and an enacted environment that encourages feelings of competence and cooperation. Surgical teams are more loosely coupled than intact and bounded. Team members tend to rely on expected role behaviours to bridge lack of familiarity. While members of the surgical team identified technical competence and preparation as critical factors affecting team performance, they had differing views over the role behaviours of other members of the surgical team that lead to surgical team performance. Observations revealed that the work climate in the OR can shape interpersonal relations and begins to be established when the room is being set up for the surgical case, and evolves as the surgical procedure progresses. The leadership and supervisory competencies of the circulating RNs establish the initial work environment. Both influenced the degree of cooperation and support that was observed, which had an effect on the interactions and relationships between other members of the surgical team. As the surgery unfolds, the surgeon's behaviours and interpersonal relations modify this environment and ultimately influence the degree of team work, team satisfaction and team performance.

  1. Fabrication of room temperature continuous-wave operation GaN-based ultraviolet laser diodes

    Science.gov (United States)

    Zhao, Degang; Yang, Jing; Liu, Zongshun; Chen, Ping; Zhu, Jianjun; Jiang, Desheng; Shi, Yongsheng; Wang, Hai; Duan, Lihong; Zhang, Liqun; Yang, Hui

    2017-06-01

    Two kinds of continuous-wave GaN-based ultraviolet laser diodes (LDs) operated at room temperature and with different emission wavelengths are demonstrated. The LDs epitaxial layers are grown on GaN substrate by metalorganic chemical vapor deposition, with a 10 × 600 μm2 ridge waveguide structure. The electrical and optical characteristics of the ultraviolet LDs are investigated under direct-current injection at room temperature. The stimulated emission peak wavelength of first LD is 392.9 nm, the threshold current density and voltage is 1.5 kA/cm2 and 5.0 V, respectively. The output light power is 80 mW under the 4.0 kA/cm2 injection current density. The stimulated emission peak wavelength of second LD is 381.9 nm, the threshold current density the voltage is 2.8 kA/cm2 and 5.5 V, respectively. The output light power is 14 mW under a 4.0 kA/cm2 injection current density. Projects the supported by the National Key R&D Program of China (Nos. 2016YFB0401801, 2016YFB0400803), the National Natural Science Foundation of China (Nos. 61674138, 61674139, 61604145, 61574135, 61574134, 61474142, 61474110, 61377020, 61376089), the Science Challenge Project (No. JCKY2016212A503), and the One Hundred Person Project of the Chinese Academy of Sciences.

  2. A Review of the Ergonomic Issues in the Laparoscopic Operating Room

    Directory of Open Access Journals (Sweden)

    Sang D. Choi

    2012-01-01

    Full Text Available This review paper discusses the ergonomic challenges associated with laparoscopy in the operating room (OR and summarizes the practical ergonomic solutions. The literature search was conducted in the fields of laparoscopy and applied ergonomics. Findings indicated that laparoscopic OR staff (surgeons, perioperative nurses and technicians commonly experienced physical and mental ergonomic risks while working in prolonged static and awkward body positions. This study highlighted the need for more ergonomic interventions in OR environment in order to improve the efficiency of laparoscopy. Ergonomic solutions included utilizing adjustable equipment, placing computer peripherals in optimal locations, providing ergonomic instruments, and improving communication. Understanding the job- or task-related ergonomic risks and hazards could help identify intervention requirements to meet the challenges associated with increased dependency on advanced high technology in the OR.

  3. Designing User Interfaces for Smart-Applications for Operating Rooms and Intensive Care Units

    Science.gov (United States)

    Kindsmüller, Martin Christof; Haar, Maral; Schulz, Hannes; Herczeg, Michael

    Today’s physicians and nurses working in operating rooms and intensive care units have to deal with an ever increasing amount of data. More and more medical devices are delivering information, which has to be perceived and interpreted in regard to patient status and the necessity to adjust therapy. The combination of high information load and insufficient usability creates a severe challenge for the health personnel with respect to proper monitoring of these devices respective to acknowledging alarms and timely reaction to critical incidents. Smart Applications are a new kind of decision support systems that incorporate medical expertise in order to help health personnel in regard to diagnosis and therapy. By means of a User Centered Design process of two Smart Applications (anaesthesia monitor display, diagnosis display), we illustrate which approach should be followed and which processes and methods have been successfully applied in fostering the design of usable medical devices.

  4. Augmented-reality visualization in iMRI operating room: system description and preclinical testing

    Science.gov (United States)

    Sauer, Frank; Khamene, Ali; Bascle, Benedicte; Vogt, Sebastian; Rubino, Gregory

    2002-05-01

    We developed an augmented reality system targeting image guidance for surgical procedures. The surgeon wears a video- see-through head mounted display that provides him with a stereo video view of the patient. The live video images are augmented with graphical representations of anatomical structures that are segmented from medical image data. The surgeon can see, e.g., a tumor in its actual location inside the patient. This in-situ visualization, where the computer maps the image information onto the patient, promises the most direct, intuitive guidance for surgical procedures. In this paper, we describe technical details of the system and its installation in UCLA's iMRI operating room. We added instrument tracking to the capabilities of our system to prepare it for minimally invasive procedures. We discuss several pre-clinical phantom experiments that support the potential clinical usefulness of augmented reality guidance.

  5. Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi

    2017-01-01

    PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract...... surgeons with different levels of experience. METHODS: Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated...... task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non...

  6. Impact of computerized information systems on workload in operating room and intensive care unit.

    Science.gov (United States)

    Bosman, R J

    2009-03-01

    The number of operating rooms and intensive care departments equipped with a clinical information system (CIS) is rapidly expanding. Amongst the putative advantages of such an installation, reduction in workload for the clinician is one of the most appealing. The scarce studies looking at workload variations associated with the implementation of a CIS, only focus on direct workload discarding indirect changes in workload. Descriptions of the various methods to quantify workload are provided. The hypothesis that a third generation CIS can reduce documentation time for ICU nurses and increase time they spend on patient care, is supported by recent literature. Though it seems obvious to extrapolate these advantages of a CIS to the anesthesiology department or physicians in the intensive care, studies examining this assumption are scarce.

  7. Wearing lead aprons in surgical operating rooms: ergonomic injuries evidenced by infrared thermography.

    Science.gov (United States)

    Alexandre, Dominique; Prieto, Marc; Beaumont, Fabien; Taiar, Redha; Polidori, Guillaume

    2017-03-01

    The purpose of this study is to quantify the impact of the weight of radiation protection lead aprons on the discomfort and the fatigue of the medical staff within an operating room of interventional gastroenterology. To quantify this fatigue, we analyzed variations of the physiological parameters, including heart rate, blood pressure, and cutaneous temperature; we compared two situations: the first within the classic endoscopy department (without apron) and the second within the operating room with apron. A follow-up study with lighter lead aprons was also conducted. We used infrared thermography as the principal method of analysis in our study. This technique permits us to obtain data, without body contact, of the spatial and temporal orientation of temperatures on subject skin. This method proves to be beneficial in the evaluation of the posture of users. The symmetry of the temperature evolution among the different body zones can contribute to the body balance analysis. Our results of the cutaneous temperatures obtained by infrared camera show significant differences in the muscular activity. All the muscular groups studied were revealed significant temperature increases. The temperature curve T2-T1 reveals the actual influence of carrying heavy apron loads. Regardless of the muscular group, this temperature increase varies on the range between 0.55°C and 0.95°C. The muscular groups most recruited are the trapezoids and pectorals. The muscles least recruited are those of the lower limbs. The study shows the impact of load bearing on the body mechanics of medical staff during work. It will be beneficial to develop this study to predict changes in skin temperature because of the various types of aprons and to determine the possible correlation between the thermal distribution and users' sense of comfort. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Anesthetic drug wastage in the operation room: A cause for concern

    Directory of Open Access Journals (Sweden)

    Kapil Chaudhary

    2012-01-01

    Full Text Available Context: The cost of anesthetic technique has three main components, i.e., disposable supplies, equipments, and anesthetic drugs. Drug budgets are an easily identifiable area for short-term savings. Aim: To assess and estimate the amount of anesthetic drug wastage in the general surgical operation room. Also, to analyze the financial implications to the hospital due to drug wastage and suggest appropriate steps to prevent or minimize this wastage. Settings and Design: A prospective observational study conducted in the general surgical operation room of a tertiary care hospital. Materials and Methods: Drug wastage was considered as the amount of drug left unutilized in the syringes/vials after completion of a case and any ampoule or vial broken while loading. An estimation of the cost of wasted drug was made. Results: Maximal wastage was associated with adrenaline and lignocaine (100% and 93.63%, respectively. The drugs which accounted for maximum wastage due to not being used after loading into a syringe were adrenaline (95.24%, succinylcholine (92.63%, lignocaine (92.51%, mephentermine (83.80%, and atropine (81.82%. The cost of wasted drugs for the study duration was 46.57% (Rs. 16,044.01 of the total cost of drugs issued/loaded (Rs. 34,449.44. Of this, the cost of wastage of propofol was maximum being 56.27% (Rs. 9028.16 of the total wastage cost, followed by rocuronium 17.80% (Rs. 2856, vecuronium 5.23% (Rs. 840, and neostigmine 4.12% (Rs. 661.50. Conclusions: Drug wastage and the ensuing financial loss can be significant during the anesthetic management of surgical cases. Propofol, rocuronium, vecuronium, and neostigmine are the drugs which contribute maximally to the total wastage cost. Judicious use of these and other drugs and appropriate prudent measures as suggested can effectively decrease this cost.

  9. Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.

    Science.gov (United States)

    Wan, Eric L; Xie, Li; Barrett, Miceile; Baltodano, Pablo A; Rivadeneira, Andres F; Noboa, Jonathan; Silver, Maya; Zhou, Richard; Cho, Suzy; Tam, Tammie; Yurter, Alp; Gentry, Carol; Palacios, Jorge; Rosson, Gedge D; Redett, Richard J

    2015-01-01

    In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions. We established a recovery and donation program to collect clean and unused supplies for healthcare institutions in developing nations. We analyzed items donated over a 3-year period (September 2010-November 2013) by quantity and weight, and estimated the projected value of the program under potential nationwide participation. To capture the health benefits attributable to the donated supplies at recipient institutions, we partnered with two tertiary-care centers in Guayaquil, Ecuador and conducted a pilot study on the utility of the donated supplies at the recipient institutions (October 2013). We determined the disability-adjusted life years (DALY) averted for all patients undergoing procedures involving donated items and estimated the annual attributable DALY as well as the cost per DALY averted both by supply and by procedure. Approximately, 2 million lbs (907,185 kg) per year of medical supplies are recoverable from large non-rural US academic medical centers. Of these supplies, 19 common categories represent a potential for donation worth US $15 million per year, at a cost-utility of US $2.14 per DALY averted. Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.

  10. Influence of the operating room schedule on tardiness from scheduled start times.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2009-06-01

    Tardiness from scheduled start times in a surgical suite is a common source of frustration for both operating room personnel and patients. Data from two surgical suites were used to investigate the relative importance of various factors that contribute to tardiness, including average case duration, time of day, prolonged turnovers, whether a surgeon follows himself or another surgeon, the potential for starting cases early, concurrency (e.g., number of residents supervised simultaneously), expected under-utilized or over-utilized time, and case duration bias. Average tardiness per case did not depend on the individual durations of preceding cases or on the relative numbers of long and short cases. In contrast, the total duration of preceding cases was important in determining tardiness. Tardiness per case grew larger as the day progressed because the total duration of preceding cases increased, but began to decline for cases scheduled to commence 6 h after the start of the workday. Tardiness was not affected by prolonged turnovers, differences in average case duration among services, or whether a surgeon followed himself or another surgeon in the same operating room. Tardiness was affected by expected under-utilized or over-utilized time at the end of the workday and by case duration bias. Factors associated with the largest numbers of cases had the biggest influence on tardiness. Greater understanding of these factors aided in the development of several mathematical interventions to reduce tardiness in the two surgical suites. These interventions and their applicability for reducing tardiness are described in a companion article. At two surgical suites, tardiness from scheduled start times did not depend on average case duration or prolonged turnovers. Tardiness did depend on the total duration of preceding cases, expected under-utilized or over-utilized time at the end of the day, and case duration bias.

  11. Development of human performance evaluation battery for integrated system validation of the HSI for an advanced control room

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, S. H. [National Chiao Tung Univ., 1001 Ta Hsueh Road, Hsinchu, 30010, Taiwan (China); Wu, T. M.; Lee, J. Y. [Dept. of Nuclear Engineering, Taiwan Power Company, 242 Roosevelt Road, Taipei, 100 Taiwan (China)

    2006-07-01

    The human-system interface (HSI) plays a vital role in the operation of a nuclear power plant. To ensure a human factors engineered advanced control room HSI design in support of reliable and safe operation of the plant, Taiwan Power Company has incorporated elements of the HFE Program Review Model (HFE PRM), prescribed in NUREG-0711 [1], into the HFE program for its Lungmen Nuclear Power Project. At present, the control room HSI design is undergoing verification and validation. Although NUREG/CR-6393[2] has introduced review criteria and methodology for integrated system validation, these criteria and methodology need to be elaborated for proper implementation. The purpose of this paper is to describe the development of suitable performance evaluation tools to be used to collect objective task performance measures, cognitive measures, as well as physical measures for HFE validation for the Lungmen project. (authors)

  12. Creating impact with operations research in health: making room for practice in academia.

    Science.gov (United States)

    Brandeau, Margaret L

    2016-12-01

    Operations research (OR)-based analyses have the potential to improve decision making for many important, real-world health care problems. However, junior scholars often avoid working on practical applications in health because promotion and tenure processes tend to value theoretical studies more highly than applied studies. This paper discusses the author's experiences in using OR to inform and influence decisions in health and provides a blueprint for junior researchers who wish to find success by taking a similar path. This involves selecting good problems to study, forming productive collaborations with domain experts, developing appropriate models, identifying the most salient results from an analysis, and effectively disseminating findings to decision makers. The paper then suggests how journals, funding agencies, and senior academics can encourage such work by taking a broader and more informed view of the potential role and contributions of OR to solving health care problems. Making room in academia for the application of OR in health follows in the tradition begun by the founders of operations research: to work on important real-world problems where operations research can contribute to better decision making.

  13. Augmented reality in neurovascular surgery: feasibility and first uses in the operating room.

    Science.gov (United States)

    Kersten-Oertel, Marta; Gerard, Ian; Drouin, Simon; Mok, Kelvin; Sirhan, Denis; Sinclair, David S; Collins, D Louis

    2015-11-01

    The aim of this report is to present a prototype augmented reality (AR) intra-operative brain imaging system. We present our experience of using this new neuronavigation system in neurovascular surgery and discuss the feasibility of this technology for aneurysms, arteriovenous malformations (AVMs), and arteriovenous fistulae (AVFs). We developed an augmented reality system that uses an external camera to capture the live view of the patient on the operating room table and to merge this view with pre-operative volume-rendered vessels. We have extensively tested the system in the laboratory and have used the system in four surgical cases: one aneurysm, two AVMs and one AVF case. The developed AR neuronavigation system allows for precise patient-to-image registration and calibration of the camera, resulting in a well-aligned augmented reality view. Initial results suggest that augmented reality is useful for tailoring craniotomies, localizing vessels of interest, and planning resection corridors. Augmented reality is a promising technology for neurovascular surgery. However, for more complex anomalies such as AVMs and AVFs, better visualization techniques that allow one to distinguish between arteries and veins and determine the absolute depth of a vessel of interest are needed.

  14. Real-time observations of stressful events in the operating room

    Directory of Open Access Journals (Sweden)

    AlNassar Sami

    2012-01-01

    Full Text Available Aim: To identify and quantify factors causing stress in the operating room (OR and evaluate the relationship between these factors and surgeons′ stress level. Methods: This is a prospective observational study from 32 elective surgical procedures conducted in the OR of King Khalid University Hospital, Riyadh, Saudi Arabia. Before each operation, each surgeon was asked of stressors. Two interns observed 16 surgeries each, separately. The interns watched and took notes during the entire surgical procedure. During each operation, the observer recorded anxiety-inducing activities and events that occurred in real time by means of a checklist of 8 potential stressors: technical, patient problems, teamwork problems, time and management issues, distractions and interruptions, equipment problems, personal problems, and teaching. After each operation, surgeons were asked to answer the validated State-Trait Anxiety Inventory questionnaire and self-report on their stress level from the 8 sources using a scale of 1-8 (1: stress free, 8: extremely stressful. The observer also recorded perceived stress levels experienced by the surgeons during the operation. Results: One hundred ten stressors were identified. Technical problems most frequently caused stress (16.4% and personal issues the least often (6.4%. Frequently encountered stressors (teaching and distractions/interruptions caused less stress to the surgeons. Technical factors, teamwork, and equipment problems occurred frequently and were also a major contributor to OR stress. All patients were discharged in good health and within 1 week of surgery. Conclusion: Certain stressful factors do occur among surgeons in the OR and can increase the potential for errors. Further research is required to determine the impact of stress on performance and the outcome of surgery.

  15. Real-time observations of stressful events in the operating room.

    Science.gov (United States)

    Sami, Alnassar; Waseem, Hajjar; Nourah, Alsubaie; Areej, Alhummaid; Afnan, Almarshedi; Ghadeer, Al-Shaikh; Abdulaziz, Alsaif; Arthur, Isnani

    2012-04-01

    To identify and quantify factors causing stress in the operating room (OR) and evaluate the relationship between these factors and surgeons' stress level. This is a prospective observational study from 32 elective surgical procedures conducted in the OR of King Khalid University Hospital, Riyadh, Saudi Arabia. Before each operation, each surgeon was asked of stressors. Two interns observed 16 surgeries each, separately. The interns watched and took notes during the entire surgical procedure. During each operation, the observer recorded anxiety-inducing activities and events that occurred in real time by means of a checklist of 8 potential stressors: technical, patient problems, teamwork problems, time and management issues, distractions and interruptions, equipment problems, personal problems, and teaching. After each operation, surgeons were asked to answer the validated State-Trait Anxiety Inventory questionnaire and self-report on their stress level from the 8 sources using a scale of 1-8 (1: stress free, 8: extremely stressful). The observer also recorded perceived stress levels experienced by the surgeons during the operation. One hundred ten stressors were identified. Technical problems most frequently caused stress (16.4%) and personal issues the least often (6.4%). Frequently encountered stressors (teaching and distractions/interruptions) caused less stress to the surgeons. Technical factors, teamwork, and equipment problems occurred frequently and were also a major contributor to OR stress. All patients were discharged in good health and within 1 week of surgery. Certain stressful factors do occur among surgeons in the OR and can increase the potential for errors. Further research is required to determine the impact of stress on performance and the outcome of surgery.

  16. Room-temperature continuous-wave operation of Ti:sapphire buried channel-waveguide lasers fabricated via proton implantation

    NARCIS (Netherlands)

    Grivas, C.; Shepherd, D.P.; Eason, R.W.; Laversenne, L.; Moretti, P.; Borca, C.N.; Pollnau, M.

    2006-01-01

    Fabrication and laser operation of proton-implanted Ti:sapphire buried channel waveguides is reported for the first time to our knowledge. Without any postimplantation annealing of the structures, continuous laser operation near 780 nm was demonstrated at room temperature at an absorbed pump power t

  17. Implementation of Software Tools for Hybrid Control Rooms in the Human Systems Simulation Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Jokstad, Håkon [Halden Reactor Project, Halden (Norway); Berntsson, Olof [Halden Reactor Project, Halden (Norway); McDonald, Robert [Halden Reactor Project, Halden (Norway); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hallbert, Bruce [Idaho National Lab. (INL), Idaho Falls, ID (United States); Fitzgerald, Kirk [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-11-01

    The Institute for Energy Technology (IFE) and Idaho National Laboratory have designed, implemented, tested and installed a functioning prototype of a set of large screen overview and procedure support displays for the Generic Pressurized Water Reactor (GPWR) simulator in the U.S. Department of Energy’s Human Systems Simulation Laboratory. The overview display is based on IFE’s extensive experiences with large screen overview displays in the Halden Man-Machine Laboratory (HAMMLAB), and presents the main control room indicators on a combined three-screen display. The procedure support displays are designed and implemented to provide a compact but still comprehensive overview of the relevant process measurements and indicators to support operators' good situational awareness during the performance of various types of procedures and plant conditions.

  18. Defining the optimal time to the operating room may salvage early trauma deaths.

    Science.gov (United States)

    Remick, Kyle N; Schwab, C William; Smith, Brian P; Monshizadeh, Amir; Kim, Patrick K; Reilly, Patrick M

    2014-05-01

    Early trauma deaths have the potential for salvage with immediate surgery. We studied time from injury to death in this group to qualify characteristics and quantify time to the operating room, yielding the greatest opportunity for salvage. The Pennsylvania Trauma Outcomes Study (PTOS) is a comprehensive registry including all Pennsylvania trauma centers. PTOS was queried for adult trauma patients from 1999 to 2010 dying within 4 hours of injury. The distribution of time to death (TD) was examined for subgroups according to mechanism of injury, hypotension (defined as systolic blood pressure ≤ 90 mm Hg), and operation required. The 5th percentile (TD5) and the 50th percentile (TD50) were calculated from the distributions and compared using the Mann-Whitney U-test. The PTOS yielded 6,547 deaths within 4 hours of injury. The overall TD5 and TD50 were 0:23 (hour:minute) and 0:59, respectively. Median penetrating injury times were significantly shorter than blunt injury times (TD5/TD50, 0:19/0:43 vs. 0:29/1:10). Median time was significantly shorter for hypotensive versus normotensive patients (TD5/TD50, 0:22/0:52 vs. 0:43/2:18). Operative subgroups had different TD5/TD50 (abdominal surgery [n = 607], 1:07/2:26; thoracic surgery [n = 756] 0:25/1:25; vascular surgery [n = 156], 0:35/2:15; and cranial surgery [n = 18], 1:20/2:42). Early trauma deaths have the potential for salvage with immediate surgery. We found TD to vary based on mechanism of injury, presence of hypotension, and type of surgery needed. With the use of TD5 and TD50 benchmarks in these subgroups, a trauma system may determine if decreased time to the operating room decreases mortality. Trauma systems can use these data to further improve prehospital and initial hospital phases of care for this subset of early death trauma patients. Epidemiologic study, level III.

  19. 手术室护理干预对颅脑损伤患者术后医院感染的控制作用研究%Effect of nursing interventions of operating rooms on control of postoperative nosocomial infections in craniocerebral injury patients

    Institute of Scientific and Technical Information of China (English)

    卜玲; 陈顺芳; 李志红

    2015-01-01

    OBJECTIVE To observe the effect of nursing interventions of operating rooms on the control of postop‐erative nosocomial infections in the patients with craniocerebral injury so as to provide guidance for clinical treat‐ment .METHODS A total of 74 patients with craniocerebral injury who received surgical procedures from Jun 2011 to Jan 2014 were recruited as the study objects and randomly divided into the control group and the observation group ,with 37 cases in each .The control group was treated with conventional surgical nursing ,while the observa‐tion group was given the intensified nursing interventions in the operating rooms ,namely to enhance the frequency and quantitative of the nursing interventions .The incidence of infections ,postoperative length of hospital stay , and acquisition of knowledge about infections were observed and compared between the two groups of patients , and the statistical analysis of data was performed with the use of SPSS 15 .0 software .RESULTS The incidence of infections of the observation group was lower than that of the control group ;the incidence of respiratory tract in‐fections was 2 .70% in the observation group ,8 .11% in the control group;the incidence of urinary tract infections was 0 in the observation group ,10 .81% in the control group ;the incidence of wound infections was 0 in the ob‐servation group ,8 .11% in the control group ,and the difference was significant (P<0 .05) .The postoperative length of hospital stay of the observation group was shorter than that of the control group .The excellent and good rate of acquisition of knowledge about infections was 67 .57% in the observation group ,higher than 45 .95% in the control group ,and the difference was significant (P<0 .05) .CONCLUSION It is an effective way to intensify the frequency and quantitative of the nursing interventions in the operating room so as to facilitate the rehabilitation of the patients and reduce the incidence of nosocomial infections

  20. Near-term improvements for nuclear power plant control room annunciator systems. [PWR; BWR

    Energy Technology Data Exchange (ETDEWEB)

    Rankin, W.L.; Duvernoy, E.G.; Ames, K.R.; Morgenstern, M.H.; Eckenrode, R.J.

    1983-04-01

    This report sets forth a basic design philosophy with its associated functional criteria and design principles for present-day, hard-wired annunciator systems in the control rooms of nuclear power plants. It also presents a variety of annunciator design features that are either necessary for or useful to the implementation of the design philosophy. The information contained in this report is synthesized from an extensive literature review, from inspection and analysis of control room annunciator systems in the nuclear industry and in related industries, and from discussions with a variety of individuals who are knowledgeable about annunciator systems, nuclear plant control rooms, or both. This information should help licensees and license applicants in improving their hard-wired, control room annunciator systems as outlined by NUREG-0700.

  1. A HUMAN FACTORS ENGINEERING PROCESS TO SUPPORT HUMAN-SYSTEM INTERFACE DESIGN IN CONTROL ROOM MODERNIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Kovesdi, C.; Joe, J.; Boring, R.

    2017-05-01

    The primary objective of the United States (U.S.) Department of Energy (DOE) Light Water Reactor Sustainability (LWRS) program is to sustain operation of the existing commercial nuclear power plants (NPPs) through a multi-pathway approach in conducting research and development (R&D). The Advanced Instrumentation, Information, and Control (II&C) System Technologies pathway conducts targeted R&D to address aging and reliability concerns with legacy instrumentation and control (I&C) and other information systems in existing U.S. NPPs. Control room modernization is an important part following this pathway, and human factors experts at Idaho National Laboratory (INL) have been involved in conducting R&D to support migration of new digital main control room (MCR) technologies from legacy analog and legacy digital I&C. This paper describes a human factors engineering (HFE) process that supports human-system interface (HSI) design in MCR modernization activities, particularly with migration of old digital to new digital I&C. The process described in this work is an expansion from the LWRS Report INL/EXT-16-38576, and is a requirements-driven approach that aligns with NUREG-0711 requirements. The work described builds upon the existing literature by adding more detail around key tasks and decisions to make when transitioning from HSI Design into Verification and Validation (V&V). The overall objective of this process is to inform HSI design and elicit specific, measurable, and achievable human factors criteria for new digital technologies. Upon following this process, utilities should have greater confidence with transitioning from HSI design into V&V.

  2. Virtual Visit to the ATLAS Control Room by Kathmandu University

    CERN Multimedia

    2013-01-01

    Kathmandu University is a not-for-profit, non-governmental institution located in Dhulikhel, Nepal. In the 20+ years of its operation, it has established itself as one of the frontrunners of higher education in the country.

  3. Integrated open loop control and design of a food storage room

    NARCIS (Netherlands)

    Mourik, van S.; Zwart, H.; Keesman, K.J.

    2009-01-01

    Usually, control design in a food storage room takes place after the plant has been designed. However, the performance of the plant connected to the controller might be improved by simultaneous design of the plant and the controller. In the case of open loop control, expressions that describe the dy

  4. Application Analysis of Evidence-based Operation Room Nursing in the Operation Room Emergency Patient Care%循证手术室护理在手术室急诊患者护理中的应用分析

    Institute of Scientific and Technical Information of China (English)

    张梅; 喻瑛; 龚俊仙

    2015-01-01

    Objective:To investigate the clinical application effect of evidence-based operation room nursing in the operation room emergency patient care,and provide a theoretical basis for improving the level of care for emergency patients.Method:100 emergency surgical patients in operation room of our hospital from February 2013 to March 2014 were retrospectively analyzed,they were randomly divided into the control group and the experimental group according to the different ways of surgical care,50 cases in each group.The patients in the control group were treated with routine care,while the patients in the experimental group were treated with routine care added evidence-based care.The clinical effects of the two groups were compared and analyzed.Result:The operative time and postoperative recovery time of the experimental group were (50.65±3.48)min,(5.47±1.62)d,which were significantly shorter than (69.47±3.62)min and (8.26±1.48)d of the control group,the differences were statistically significant(P<0.05).The nursing satisfaction of the experimental group was 96.0%(48/50),which was significantly higher than 72.0%(36/50) of the control group, the incidence of adverse reactions in the experimental group was 4.0%(2/50),which significantly lower than 26.0%(13/50) in the control group,the differences were statistically significant(P<0.05).The scores of depression,anxiety, hostility,fear in the experimental group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Application of evidence-based operation room nursing in the operation room emergency patient care can improve the quality of nursing care,decrease the postoperative recovery time,increase the satisfaction of emergency surgical patients,lower the incidence of adverse reactions,with obvious clinical practice value,it is worthy of further promotion and application.%目的:探讨循证手术护理在手术室急诊患者护理中的临床应用

  5. Operating room team members' views of workload, case difficulty, and nonroutine events.

    Science.gov (United States)

    Minnick, Ann F; Donaghey, Beth; Slagle, Jason; Weinger, Matthew B

    2012-01-01

    Interventions such as mandatory "time-outs" have contributed to intraoperative safety but improvements are still necessary. We present data provided by 3 professions always present in the intraoperative setting that suggest next steps in the quest for improvements. We describe the differences and similarities in operating room (OR) nurses', anesthesia providers', and surgeons' beliefs about team function, case difficulty, nonroutine event (NRE), and error causation using a qualitative design at 3 Veterans' Administration hospitals. Intraoperative errors are costly in lives, suffering, and dollars. A quality improvement tenet states that workers are a rich information source regarding the context within which quality can be improved. Identifying and describing OR providers' beliefs are necessary steps in devising novel approaches to quality improvement. Intraoperative NRE and error prevention opportunities exist within and outside of the OR. There may be "cascade" and "perfect storm conditions" before and during operative procedures that increase the likelihood of NREs. Confirmation of these phenomena could improve prediction and prevention of NREs. Exploration of differences in team definition and team performance ratings by provider type may also identify avenues for improvement.

  6. Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training.

    Science.gov (United States)

    Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi; Højgaard-Olsen, Klavs; Subhi, Yousif; Saleh, George M; Park, Yoon Soo; la Cour, Morten; Konge, Lars

    2017-04-01

    To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. Multicenter masked clinical trial. Eighteen cataract surgeons with different levels of experience. Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  7. Above room temperature continuous wave operation of a broad-area quantum-cascade laser

    Science.gov (United States)

    Semtsiv, M. P.; Masselink, W. T.

    2016-11-01

    We describe the design and implementation of a broad-area (w ≈ 30 μm) quantum-cascade laser operating in a continuous wave mode up to heat-sink temperatures beyond +100 °C. The room-temperature emission wavelength is 4.6 μm. The temperature gradient in the active region of such a wide laser stripe is essentially perpendicular to the epitaxial layers and the resulting steady-state active region temperature offset scales approximately with the square of the number of cascades. With only 10 cascades in the active region, the threshold electrical power density in the current quantum-cascade laser in the continuous-wave mode is as low as Vth × Ith = 3.8 V × 0.9 kA/cm2 = 3.4 kW/cm2 at room temperature for 2 mm-long two-side high-reflectivity coated laser stripe. A 4 mm-long one-side high-reflectivity coated laser stripe delivers in continuous-wave mode above 0.6 W at +20 °C and above 1.3 W at -27 °C (cooled with a single-stage Peltier element). A 2 mm-long two-side high-reflectivity coated laser stripe demonstrates continuous-wave lasing up to at least +102 °C (375 K). The thermal conductance, Gth, ranges between 235 W/K cm2 and 140 W/K cm2 for temperatures between -33 °C and +102 °C. This demonstration opens the route for continuous-wave power scaling of quantum-cascade lasers via broad-area laser ridges.

  8. Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

    Science.gov (United States)

    Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

    2013-01-01

    Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

  9. Use of an operating microscope during spine surgery is associated with minor increases in operating room times and no increased risk of infection.

    Science.gov (United States)

    Basques, Bryce A; Golinvaux, Nicholas S; Bohl, Daniel D; Yacob, Alem; Toy, Jason O; Varthi, Arya G; Grauer, Jonathan N

    2014-10-15

    Retrospective database review. To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection. Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk of infection. The American College of Surgeons National Surgical Quality Improvement Program database, which includes data from more than 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without the use of an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly conducted to test the association between microscope use and infection occurrence within 30 days of surgery. A total of 23,670 elective spine procedures were identified, of which 2226 (9.4%) used an operating microscope. The average patient age was 55.1±14.4 years. The average operative time (incision to closure) was 125.7±82.0 minutes.Microscope use was associated with minor increases in preoperative room time (+2.9 min, P=0.013), operative time (+13.2 min, Pmicroscope and nonmicroscope groups for occurrence of any infection, superficial surgical site infection, deep surgical site infection, organ space infection, or sepsis/septic shock, regardless of surgery type. We did not find operating room times or infection risk to be significant deterrents for use of an operating microscope during spine surgery. 3.

  10. Method of Evidence-Based Intervention for Nosocomial Infection in Operation Room%手术室医院感染循证干预方法

    Institute of Scientific and Technical Information of China (English)

    张雯璟

    2015-01-01

    目的:降低手术室医院感染的危险,保障医疗护理安全。方法对手术室存在的医院感染危险因素及原因进行分析。结果通过对手术室的空气、物体表面、医护人员的手、麻醉用具进行细菌监测,手术器械集中管理,合理使用抗菌药物及加强职业安全防护等,可有效控制手术室医院感染。结论实施手术室医院感染循证干预,重视每一个环节,实施规范化的综合预防措施,才能保证手术患者及手术人员的安全。%Objective To reduce the risk of operating room of hospital infection,to ensure the safety of medical care.Methods The hospital infection risk factors existing in the operating room and the reasons were analyzed.Results Through to the operating room air,surfaces,medical personnel hand,bacteria monitoring anesthesia equipment,surgical instruments centralized management and rational use of antimicrobial agents and strengthening occupational safety protection,etc.,which can ef ectively control the operating room of hospital infection.Conclusion The implementation of the operating room of hospital infection of evidence-based interventions,at ach importance to every link,the implementation of standardized comprehensive prevention measures,to ensure the safety of surgery patients and staf .

  11. Software Development for Remote Control and Firing Room Displays

    Science.gov (United States)

    Zambrano Pena, Jessica

    2014-01-01

    The Launch Control System (LCS) developed at NASA's Kennedy Space Center (KSC) will be used to launch future spacecraft. Two of the many components of this system are the Application Control Language (ACL) and remote displays. ACL is a high level domain specific language that is used to write remote control applications for LCS. Remote displays are graphical user interfaces (GUIs) developed to display vehicle and Ground Support Equipment (GSE) data, they also provide the ability to send commands to control GSE and the vehicle. The remote displays and the control applications have many facets and this internship experience dealt with several of them.

  12. HVAC controls: Operation and maintenance

    Energy Technology Data Exchange (ETDEWEB)

    Gupton, G.W. Jr.

    1987-01-01

    The introductory chapters review HVAC system processes and equipment, control system types and equipment, and equipment-to-control interactions. The succeeding chapters cover specific control systems functions, including electrical interlock and motor starting, electrical and electronic control system diagrams, pneumatic control system diagrams, air supply to pneumatic control systems, and control system maintenance.

  13. Human factors design, verification, and validation for two types of control room upgrades at a nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Boring, Laurids Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-10-01

    This paper describes the NUREG-0711 based human factors engineering (HFE) phases and associated elements required to support design, verification and validation (V&V), and implementation of a new plant process computer (PPC) and turbine control system (TCS) at a representative nuclear power plant. This paper reviews ways to take a human-system interface (HSI) specification and use it when migrating legacy PPC displays or designing displays with new functionality. These displays undergo iterative usability testing during the design phase and then undergo an integrated system validation (ISV) in a full scope control room training simulator. Following the successful demonstration of operator performance with the systems during the ISV, the new system is implemented at the plant, first in the training simulator and then in the main control room.

  14. REVIEW Of COMPUTERIZED PROCEDURE GUIDELINES FOR NUCLEAR POWER PLANT CONTROL ROOMS

    Energy Technology Data Exchange (ETDEWEB)

    David I Gertman; Katya Le Blanc; Ronald L Boring

    2011-09-01

    Computerized procedures (CPs) are recognized as an emerging alternative to paper-based procedures for supporting control room operators in nuclear power plants undergoing life extension and in the concept of operations for advanced reactor designs. CPs potentially reduce operator workload, yield increases in efficiency, and provide for greater resilience. Yet, CPs may also adversely impact human and plant performance if not designed and implemented properly. Therefore, it is important to ensure that existing guidance is sufficient to provide for proper implementation and monitoring of CPs. In this paper, human performance issues were identified based on a review of the behavioral science literature, research on computerized procedures in nuclear and other industries, and a review of industry experience with CPs. The review of human performance issues led to the identification of a number of technical gaps in available guidance sources. To address some of the gaps, we developed 13 supplemental guidelines to support design and safety. This paper presents these guidelines and the case for further research.

  15. AN IMPACT OF THE EFFICIENT FUNCTIONING OF THE VENTILATION AND AIR-CONDITIONING SYSTEM ON THERMAL COMFORT OF THE MEDICAL STAFF IN THE OPERATING ROOM

    Directory of Open Access Journals (Sweden)

    Tomasz Jankowski

    2016-11-01

    operating room were deter-mined on the basis of VelociCalc 8360 and Testo 435 anemometers with a 3-function probe and 3 vane probes with the diameter of 16 mm, 60 mm and 100 mm. Throughout the study, microclimate conditions in the operating rooms were controlled by the EHA MM101 microclimate meter. Test results showed that the microclimate parameters met the requirements of the aforementioned documents. However, individual thermal sensations reported by the medical staff pointed to the lack of thermal comfort and, in extreme cases, e.g. when using lead aprons during operations, perception of the thermal environment as ‘very hot’. The efficiency and type of air distribution in operating rooms has a decisive effect on the results.

  16. Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses

    OpenAIRE

    Moazzami, Zeinab; Dehdari, Tahere; Taghdisi, Mohammad Hosein; Soltanian, Alireza

    2015-01-01

    Background: One of the preventive strategies for chronic low back pain among operating room nurses is instructing proper body mechanics and postural behavior, for which the use of the Transtheoretical Model (TTM) has been recommended. Methods: Eighty two nurses who were in the contemplation and preparation stages for adopting correct body posture were randomly selected (control group = 40, intervention group = 42). TTM variables and body posture were measured at baseline and again after 1 and...

  17. [Nursing professionals and health care assistants' perception of patient safety culture in the operating room].

    Science.gov (United States)

    Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto

    2015-01-01

    To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  18. 手术室巡回护士的护理工作%Operating Room Nurses Tour of Nursing Work

    Institute of Scientific and Technical Information of China (English)

    李安祥

    2015-01-01

    the operating room is the place that provide patients with surgery and rescue,is an important technology of the hospital departments.operating room should have with different surgery department,but also with the guard room,anesthesia recovery room in the blood bank,etc.Pays special attention to the incision infection management of four ways, namely:the operating room air, the items needed for the operation,the ifngers of the doctors and nurses and the patient’s skin,prevent infection,to ensure the success rate of surgery.request reasonable design, equipment is well-found,the nurses work is responsive,quick,efifcient work efifciency.Patients into the operating room nursing work to be done by a visiting nurse.%手术室是为病人提供手术及抢救的场所,是医院的重要技术部门。手术室应与手术科室相接连,还要与血库、临护室、麻醉复苏室等临近。抓好手术切口感染四条途径的环节管理,即:手术室的空气、手术所需的物品、医生护士的手指及病人的皮肤,防止感染,确保手术成功率。要求设计合理,设备齐全,护士工作反应灵敏、快捷,有高效的工作效率。患者进入手术室的护理工作由巡回护士完成。

  19. PHYSICAL FIDELITY CONSIDERATIONS FOR NRC ADVANCED REACTOR CONTROL ROOM TRAINING SIMULATORS USED FOR INSPECTOR/EXAMINER TRAINING

    Energy Technology Data Exchange (ETDEWEB)

    Branch, Kristi M.; Mitchell, Mark R.; Miller, Mark; Cochrum, Steven

    2010-11-07

    This paper describes research into the physical fidelity requirements of control room simulators to train U.S. Nuclear Regulatory Commission (NRC) staff for their duties as inspectors and license examiners for next-generation nuclear power plants. The control rooms of these power plants are expected to utilize digital instrumentation and controls to a much greater extent than do current plants. The NRC is assessing training facility needs, particularly for control room simulators, which play a central role in NRC training. Simulator fidelity affects both training effectiveness and cost. Research has shown high simulation fidelity sometimes positively affects transfer to the operational environment but sometimes makes no significant difference or actually impedes learning. The conditions in which these different effects occur are often unclear, especially for regulators (as opposed to operators) about whom research is particularly sparse. This project developed an inventory of the tasks and knowledges, skills, and abilities that NRC regulators need to fulfill job duties and used expert panels to characterize the inventory items by type and level of cognitive/behavioral capability needed, difficulty to perform, importance to safety, frequency of performance, and the importance of simulator training for learning these capabilities. A survey of current NRC staff provides information about the physical fidelity of the simulator on which the student trained to the control room to which the student was assigned and the effect lack of fidelity had on learning and job performance. The study concludes that a high level of physical fidelity is not required for effective training of NRC staff.

  20. The scenario-based approach adopted in the ELECTRA project for deriving innovate control room functionality

    DEFF Research Database (Denmark)

    Marinelli, Mattia; Heussen, Kai; Prostejovsky, Alexander

    2017-01-01

    . The paper intends to outline the methodology adopted, which is based on the cognitive work analysis framework, to provide an overview of the most interesting scenarios and to summarize the requirements analysis results. In order to derive required control room functionality, a set of relevant control room...... scenarios have been identified based on the Web-of-Cells control concept. We considered scenarios that challenge traditional control schemes, scenarios that caused major failures (i.e., blackouts) and scenarios that can be expected to appear in the future. For each scenario, information concerning network...

  1. Temperature distribution in Risø Flexhouse Room 3 with different heating control principles

    DEFF Research Database (Denmark)

    Simone, Angela; Rode, Carsten

    2009-01-01

    in winter and spring 2009 to study the distribution of local temperatures in the room – particularly with the purpose to compare with the temperature measured and logged by the heating control sensor which was already installed in the room. The measured data shall be used together with mathematical models...... to predict the overall dynamic thermal properties of the building. The project is part of a wider complex of projects on predicting the electricity and heating energy consumption in dwellings....

  2. Photodetector development at Fraunhofer IAF: From LWIR to SWIR operating from cryogenic close to room temperature

    Science.gov (United States)

    Daumer, V.; Gramich, V.; Müller, R.; Schmidt, J.; Rutz, F.; Stadelmann, T.; Wörl, A.; Rehm, R.

    2017-02-01

    Photodetectors in the non-visible region of the electromagnetic spectrum are essential for security, defense and space science as well as industrial and scientific applications. The research activities at Fraunhofer IAF cover a broad range in the infrared (IR) regime. Whereas short-wavelength IR (SWIR, <1.7 μm) detectors are realized by InGaAs/InP structures, InAs/GaSb type-II superlattice (T2SL) infrared detectors are developed for the spectral bands from mid- (MWIR, 3-5 μm) to long-wavelength IR (LWIR, 8-12 μm). We report on the extension of the superlattice empirical pseudopotential method (SEPM) to 300 K for the design of LWIR heterostructures for operation near room temperature. Recently, we have also adapted heterostructure concepts to our well established bi-spectral T2SL MWIR detector resulting in a dark current density below 2 × 10-9 A/cm2 for a cut-off wavelength close to 5 μm. Finally, we present first results obtained with a gated viewing system based on our InGaAs/InAlAs/InP avalanche photodiode arrays.

  3. Implementation of a preoperative briefing protocol improves accuracy of teamwork assessment in the operating room.

    Science.gov (United States)

    Paige, John T; Aaron, Deborah L; Yang, Tong; Howell, D Shannon; Hilton, Charles W; Cohn, Isidore; Chauvin, Sheila W

    2008-09-01

    This study examined the effect of implementing a new preoperative briefing protocol on self- and peer-assessments of individual operating room (OR) teamwork behaviors. From July 2006 to February 2007, OR teamwork performance at a rural community hospital was evaluated before and after training and implementation of the protocol. After each case, every member on the team completed a 360-degree type teamwork behavior evaluation containing both self- and peer-assessments using a six-point Likert type scale (1 = definitely no to 6 = definitely yes). Individual behavior change was measured using the mean scale score of pre and postprotocol assessments. Statistical analysis included t test for both pre/post and self/peer differences. Data were available for one general surgeon and nine OR staff (pre = 20 cases, post = 16 cases). The preprotocol self-assessment mean score was significantly higher than peer-assessment (5.63 vs 5.29, P teamwork behaviors. No difference was observed in postassessment mean scores for self- and peer-assessments. Individuals overestimated their teamwork behaviors before protocol implementation. Using a preoperative protocol seems to improve OR staff teamwork behaviors and self-assessment accuracy. The use of a 360-degree assessment method targeting specific, observable behaviors may be useful in evaluating team-based interventions and enhancing teamwork effectiveness.

  4. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.

    Science.gov (United States)

    Kadry, Bassam; Press, Christopher D; Alosh, Hassan; Opper, Isaac M; Orsini, Joe; Popov, Igor A; Brodsky, Jay B; Macario, Alex

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P 35 kg/m(2) each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  5. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    Bassam Kadry

    2014-08-01

    Full Text Available Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI in patients undergoing total hip arthroplasty (THA with different components of operating room (OR time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  6. [Evaluation of Radiation Dose during Stent-graft Treatment Using a Hybrid Operating Room System].

    Science.gov (United States)

    Haga, Yoshihiro; Chida, Kouichi; Kaga, Yuji; Saitou, Kazuhisa; Arai, Takeshi; Suzuki, Shinichi; Iwaya, Yoshimi; Kumasaka, Eriko; Kataoka, Nozomi; Satou, Naoto; Abe, Mitsuya

    2015-12-01

    In recent years, aortic aneurysm treatment with stent graft grafting in the X-ray fluoroscopy is increasing. This is an endovascular therapy, because it is a treatment which includes the risk of radiation damage, having to deal with radiation damage, to know in advance is important. In this study, in order to grasp the trend of exposure stent graft implantation in a hybrid operating room (OR) system, focusing on clinical data (entrance skin dose and fluoroscopy time), was to count the total. In TEVAR and EVAR, fluoroscopy time became 13.40 ± 7.27 minutes, 23.67 ± 11.76 minutes, ESD became 0.87 ± 0.41 mGy, 1.11 ± 0.57 mGy. (fluoroscopy time of EVAR was 2.0 times than TEVAR. DAP of EVAR was 1.2 times than TEVAR.) When using the device, adapted lesions and usage are different. This means that care changes in exposure-related factors. In this study, exposure trends of the stent graft implantation was able to grasp. It can be a helpful way to reduce/optimize the radiation dose in a hybrid OR system.

  7. The effects of general anesthesia legislation on operating room visits by preschool children undergoing dental treatment.

    Science.gov (United States)

    White, Halley R; Lee, Jessica Y; Rozier, R Gary

    2008-01-01

    The purpose of this study was to examine the impact of state-level general anesthesia (GA) legislation on operating room visits for the treatment of dental caries on preschool-aged children. The North Carolina Ambulatory Surgery Discharge Database was used to observe GA visits for fiscal years (FY) 1997 to 2001. A pretest/post-test design with concurrent comparison groups was used for 2 analyses: (1) all children treated for dental caries were compared to those treated for otitis media; and (2) those whose treatment for dental caries was reimbursed by Medicaid were compared to those whose treatment for dental caries was not reimbursed by Medicaid. In the prelegislation period (FY 1997 and 1998), there were 3,857 GA visits for dental core and 21,038 for otitis media. Postlegislation (FY 2000 and 2001) dental visits increased to 5,511(43%), and otitis media visits increased to 22,279 (6%)-a statistically significant difference (Pdental visits and 2,487 Medicaid dental visits. Non-Medicaid and Medicaid dental visits postlegislation increased to 2,195 (60%) and 3,316 (33%), respectively. This difference was significant (Panesthesia legislation resulted in an increase in access to care for children needing dental care in North Carolina.

  8. Learning from Aviation to Improve Safety in the Operating Room - a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Linda S. G. L. Wauben

    2012-01-01

    Full Text Available Lessons learned from other high-risk industries could improve patient safety in the operating room (OR. This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed and Scopus databases were systematically searched for relevant articles written in the English language published between 2000 and 2011. In total, 25 articles were included, all within the medical domain focusing on the comparison between surgery and aviation. In order to improve safety in the OR, multiple interventions have to be implemented. Additionally, the healthcare organization has to become a ‘learning organization’ and the OR team has to become a team with shared responsibilities and flat hierarchies. Interpersonal and technical skills can be trained by means of simulation and can be supported by implementing team briefings, debriefings and cross-checks. However, further development and research is needed to prove if these solutions are useful, practical, and actually increase safety.

  9. [Who is suited as operation room manager? Evaluation process for hospitals and candidates].

    Science.gov (United States)

    Schüpfer, G; Bauer, M

    2011-03-01

    Operation room (OR) management is not an end in itself. The challenge is more to organize the complex, inhomogeneous and interference-prone machinery of intraoperative service provision according to business objectives. Although business objectives may differ in some details the ultimate consequence is always to assure the quality of medical care along with adhering to the general economic conditions. The narrower the economic framework the smaller the company's tolerance to unprofessional OR management. Consequently, it can be noticed that OR management has become of age. An internal socialization as frontline leader is no longer sufficient for taking over a job profile which, regarding the risks of revenues and costs belongs to the top management of a company. Prior to looking for a future OR manager it is mandatory to develop a profile of qualifications tailored to the company. In the following selection process the important thing is to identify the candidate who fits best to the developed profile. This paper sees itself as an assistance in the development of such a company-specific qualification profile for an OR manager. On the basis of knowledge, skills and characteristics, different manager typologies are developed, facilitating the successful evaluation in a selection process for both the company and the candidate.

  10. Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.

    Science.gov (United States)

    Van Houdenhoven, Mark; van Oostrum, Jeroen M; Hans, Erwin W; Wullink, Gerhard; Kazemier, Geert

    2007-09-01

    An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. We applied advanced mathematical algorithms in combination with scenarios that model relaxation of various organizational barriers using prospectively collected data. The setting is the main inpatient OR department of a university hospital, which sets its surgical case schedules 2 wk in advance using a block planning method. The main outcome measures are the number of freed OR blocks and OR utilization. Lowering organizational barriers and applying mathematical algorithms can yield a 4.5% point increase in OR utilization (95% confidence interval 4.0%-5.0%). This is obtained by reducing the total required OR time. Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.

  11. The Effect of Instructional Supervision by an Operating Room Assistant on First-Case Starts.

    Science.gov (United States)

    Pan, Xiaohua; Zhang, Jun; Dai, Chen; Si, Yibing

    2017-02-01

    Delays in starting first cases of the day are a common topic associated with high economic costs. This study aimed to determine if an operating room (OR) assistant using an instructional supervision program could reduce the tardiness of first-case starts. A prospective study was conducted. Data from four ORs were used to compare the effectiveness of an instructional intervention to reduce delays in starting first cases of the day. The first cases in two ORs received instructional supervision by an OR. The primary endpoint was the percentage of first cases that started on time. Other endpoints were the percentage of the team work score of OR staff and the percentage of patient satisfaction score. Over 48 weeks, the effect of instructional supervision was evaluated in 960 first-case starts. In the instructional supervision group (n = 480), the percentage of first cases that started on time increased significantly (92.1% vs 71.7%; P < .001), and there was a higher percentage of the team work score (84.4% vs 76.7%; P < .01) and patient satisfaction score (88.3% vs 79.4%; P < .001). Instructional supervision by an OR assistant can make a potential improvement in our on-time first-case starts per day. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  12. Operating Room Efficiency before and after Entrance in a Benchmarking Program for Surgical Process Data.

    Science.gov (United States)

    Pedron, Sara; Winter, Vera; Oppel, Eva-Maria; Bialas, Enno

    2017-08-23

    Operating room (OR) efficiency continues to be a high priority for hospitals. In this context the concept of benchmarking has gained increasing importance as a means to improve OR performance. The aim of this study was to investigate whether and how participation in a benchmarking and reporting program for surgical process data was associated with a change in OR efficiency, measured through raw utilization, turnover times, and first-case tardiness. The main analysis is based on panel data from 202 surgical departments in German hospitals, which were derived from the largest database for surgical process data in Germany. Panel regression modelling was applied. Results revealed no clear and univocal trend of participation in a benchmarking and reporting program for surgical process data. The largest trend was observed for first-case tardiness. In contrast to expectations, turnover times showed a generally increasing trend during participation. For raw utilization no clear and statistically significant trend could be evidenced. Subgroup analyses revealed differences in effects across different hospital types and department specialties. Participation in a benchmarking and reporting program and thus the availability of reliable, timely and detailed analysis tools to support the OR management seemed to be correlated especially with an increase in the timeliness of staff members regarding first-case starts. The increasing trend in turnover time revealed the absence of effective strategies to improve this aspect of OR efficiency in German hospitals and could have meaningful consequences for the medium- and long-run capacity planning in the OR.

  13. Surgical clothing systems in laminar airflow operating room: a numerical assessment.

    Science.gov (United States)

    Sadrizadeh, Sasan; Holmberg, Sture

    2014-01-01

    This study compared two different laminar airflow distribution strategies - horizontal and vertical - and investigated the effectiveness of both ventilation systems in terms of reducing the sedimentation and distribution of bacteria-carrying particles. Three different staff clothing systems, which resulted in source strengths of 1.5, 4 and 5 CFU/s per person, were considered. The exploration was conducted numerically using a computational fluid dynamics technique. Active and passive air sampling methods were simulated in addition to recovery tests, and the results were compared. Model validation was performed through comparisons with measurement data from the published literature. The recovery test yielded a value of 8.1 min for the horizontal ventilation scenario and 11.9 min for the vertical ventilation system. Fewer particles were captured by the slit sampler and in sedimentation areas with the horizontal ventilation system. The simulated results revealed that under identical conditions in the examined operating room, the horizontal laminar ventilation system performed better than the vertical option. The internal constellation of lamps, the surgical team and objects could have a serious effect on the movement of infectious particles and therefore on postoperative surgical site infections.

  14. Advertised sustainability practices among suppliers to a university hospital operating room.

    Science.gov (United States)

    Schieble, Thomas M

    2008-01-01

    The present study aimed to identify firms supplying products to our university operating room (OR) that promote sustainable manufacturing methods. Results show that 72% of our suppliers, or 152 of 211 companies, do not promote sustainability practices in a salient manner. Multi-national firms document sustainability methods significantly more than U.S. divisions of multi-nationals or U.S. firms with chi-square = 157.93 (p sustainability promotion is an important marketing tool through which purchasers may begin the process of due diligence for product selection. Lack of sustainability information among suppliers in this study suggests that hospital procurement departments likely focus solely on issues like price or quality when making purchase decisions. These results also suggest an opportunity for healthcare administrators to evaluate more fully the products involved in the healthcare supply chain; the intrinsic, intangible value added to hospital products through sustainable manufacturing is consistent with responsible patient care and has the potential to create marketing and public relations value.

  15. Co-operatives and Normative Control

    DEFF Research Database (Denmark)

    Bregn, Kirsten; Jagd, Søren

    1992-01-01

    This paper explores the conditions for applying normative control in co-operatives. For normative control to be effective two conditions are found particularly important: Individuals must be morally involved and the organization must have a system of making it possible to link common norms...... and individual action. If these conditions are not fulfilled, as may be the case in many co-operatives, normative control cannot be expected to work. The problems of normative control in co-operatives may then not be caused by the use of normative control as such, but may instead be a problem of securing...... the conditions necessary for normative control. This is illustrated by a case study of control in a Danish producers co-operative. The analysis of the case study leads to the hypothesis of a paradox of normative control in co-operatives: The need of information tends to be greater in co-operatives comparet...

  16. Reducing tardiness from scheduled start times by making adjustments to the operating room schedule.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2009-06-01

    Tardiness from scheduled start times is a common source of frustration for both operating room (OR) personnel and patients. Factors that influence tardiness were quantified in a companion paper and have been used to develop interventions that have the potential for reducing tardiness. Data from two surgical suites were used to compare the effectiveness of several interventions to reduce tardiness, including i) moving cases to different ORs on the afternoon of surgery, ii) recalculating the OR schedule when it is published to correct for average lateness in first cases of the day, iii) recalculating the OR schedule when it is published to correct for average service-specific case duration bias, and iv) scheduling a gap (time buffer) before the cases of a "to follow" surgeon if the day is expected to end early. These last three interventions involve creation of a modified schedule with revised start times that are more accurate for both patient and "to follow" surgeon. The surgeon performing the first case of the day would not be affected. Moving cases to different ORs when a room was running late produced a 50%-70% reduction in the tardiness for those cases that were moved. However, overall tardiness in each suite was reduced by only 6%-9%, because few cases were moved. Scheduling a gap between surgeons if the day was expected to end early reduced tardiness by more than 50% for those cases that were preceded by gaps. However, overall tardiness in each suite was reduced by only 4%-8%, because few gaps could be scheduled. In contrast, correcting for the combination of lateness in first cases of the day and service-specific case duration bias reduced overall tardiness in each suite by 30%-35%. Interventions which involve small numbers of cases have little potential to reduce overall tardiness. Generating a modified or auxiliary OR schedule that compensates for known causes of tardiness can significantly reduce patient and "to follow" surgeon waiting times. Modifying

  17. Equipment-related incidents in the operating room: an analysis of occurrence, underlying causes and consequences for the clinical process

    NARCIS (Netherlands)

    Wubben, I.; van Manen, Jeanette Gabrielle; van den Akker, B.J.; Vaartjes, S.R.; van Harten, Willem H.

    2010-01-01

    Background: Equipment-related incidents in the operating room (OR) can affect quality of care. In this study, the authors determined the occurrence and effects on the care process in a large teaching hospital. - Methods: During a 4-week period, OR nurses reported equipment-related incidents during

  18. Practice Brief: Accommodating Deaf and Hard of Hearing Students in Operating Room Environments--A Case Study

    Science.gov (United States)

    Meeks, Lisa M.; Laird-Metke, Elisa; Rollins, Mark; Gandhi, Seema; Stechert, Martin; Jain, Neera R.

    2015-01-01

    Increasing numbers of deaf students in the health professions require accommodations in the clinical setting to ensure effective learning and accurate communication. Although classroom learning barriers have long been identified and addressed, barriers to clinical education have been far less analyzed. Operating room clerkships, which include many…

  19. Risk-sensitive events during laparoscopic cholecystectomy: the influence of the integrated operating room and a preoperative checklist tool

    NARCIS (Netherlands)

    Buzink, S.N.; Van Lier, L.; De Hingh, I.H.J.T.; Jakimowicz, J.J.

    2010-01-01

    Background - Awareness of the relative high rate of adverse events in laparoscopic surgery created a need to safeguard quality and safety of performance better. Technological innovations, such as integrated operating room (OR) systems and checklists, have the potential to improve patient safety, OR

  20. Countermeasures for nursing errors in operation room%手术室护理差错的防范对策

    Institute of Scientific and Technical Information of China (English)

    李淑文

    2015-01-01

    本文分析手术室护理差错的原因及防范对策,最大限度防止护理差错的发生。%this paper analyzes the causes of nursing errors in operation room and its preventive measures,and can prevent the occurrence of nursing errors..

  1. Risk-sensitive events during laparoscopic cholecystectomy: the influence of the integrated operating room and a preoperative checklist tool

    NARCIS (Netherlands)

    Buzink, S.N.; Van Lier, L.; De Hingh, I.H.J.T.; Jakimowicz, J.J.

    2010-01-01

    Background - Awareness of the relative high rate of adverse events in laparoscopic surgery created a need to safeguard quality and safety of performance better. Technological innovations, such as integrated operating room (OR) systems and checklists, have the potential to improve patient safety, OR

  2. Condition-based Human Reliability Assessment for digitalized control room

    Energy Technology Data Exchange (ETDEWEB)

    Kang, H. G.; Jang, S. C.; Eom, H. S.; Ha, J. J

    2005-04-01

    In safety-critical systems, the generation failure of an actuation signal is caused by the concurrent failures of the automated systems and an operator action. These two sources of safety signals are complicatedly correlated. The failures of sensors or automated systems will cause a lack of necessary information for a human operator and result in error-forcing contexts such as the loss of corresponding alarms and indications. In the conventional analysis, the Human Error Probabilities (HEP) are estimated based on the assumption of 'normal condition of indications and alarms'. In order to construct a more realistic signal-generation failure model, we have to consider more complicated conditions in a more realistic manner. In this study, we performed two kinds of investigation for addressing this issue. We performed the analytic calculations for estimating the effect of sensors failures on the system unavailability and plant risk. For the single-parameter safety signals, the analysis result reveals that the quantification of the HEP should be performed by focusing on the 'no alarm from the automatic system and corresponding indications unavailable' situation. This study also proposes a Condition-Based Human Reliability Assessment (CBHRA) method in order to address these complicated conditions in a practical way. We apply the CBHRA method to the manual actuation of the safety features such as a reactor trip and auxiliary feedwater actuation in Korean Standard Nuclear Power Plants. In the case of conventional single HEP method, it is very hard to consider the multiple HE conditions. The merit of CBHRA is clearly shown in the application to the AFAS generation where no dominating HE condition exits. In this case, even if the HE conditions are carefully investigated, the single HEP method cannot accommodate the multiple conditions in a fault tree. On the other hand, the application result of the reactor trip in SLOCA shows that if there is a

  3. High Level Control Applications for SOLEIL Commissioning and Operation

    CERN Document Server

    Nadolski, Laurent S; Ho, Katy; Leclercq, Nicolas; Ounsy, Majid; Petit, Sylvain

    2005-01-01

    The SOLEIL control system, namely TANGO developed in collaboration with ESRF, is now mature and stable. TANGO has also been chosen now by several other laboratories. High-level control applications implemented in the control room for the storage ring, the two transfer lines, and the booster will be described in this paper. Three kinds of tools for commissioning are used. First the generic TANGO tools (alarms, simple graphical control applications), which allow us to control in a simple way any TANGO Device Server. Secondly a Matlab Middle Layer (adapted from ALS and SPEAR3): Matlab is fully interconnected with TANGO; it is used primarily for writing Physics control applications. Finally Globalscreen, a commercial SCADA software devoted for building operation applications has been selected (panels for controlling or displaying setpoint, readback values, status of equipments). In addition an overview of the historical and short-term databases for the accelerators will be given. They have been developed in house...

  4. Closed-Loop Acoustic Control of Reverberant Room for Satellite Environmental Testing

    Science.gov (United States)

    Janssens, Karl; Bianciardi, Fabio; Sabbatini, Danilo; Debille, Jan; Carrella, Alex

    2012-07-01

    The full satellite acoustic test is an important milestone in a satellite launch survivability verification campaign. This test is required to verify the satellite’s mechanical design against the high-level acoustic loads induced by the launch vehicle during the atmospheric flight. During the test, the satellite is subjected to a broadband diffuse acoustic field, reproducing the pressure levels observed during launch. The excitation is in most cases provided by a combination of horns for the low frequencies and noise generators for the higher frequencies. Acoustic control tests are commonly performed in reverberant rooms, controlling the sound pressure levels in third octave bands over the specified target spectrum. This paper discusses an automatic feedback control system for acoustic control of large reverberation rooms for satellite environmental testing. The acoustic control system consists of parallel third octave PI (Proportional Integral) feedback controllers that take the reverberation characteristics of the room into consideration. The drive output of the control system is shaped at every control step based on the comparison of the average third octave noise spectrum, measured from a number of microphones in the test room, with the target spectrum. Cross-over filters split the output drive into band- limited signals to feed each of the horns. The control system is realized in several steps. In the first phase, a dynamic process model is developed, including the non-linear characteristics of the horns and the reverberant properties of the room. The model is identified from dynamic experiments using system identification techniques. In the next phase, an adequate control strategy is designed which is capable of reaching the target spectrum in the required time period without overshoots. This control strategy is obtained from model-in-the-loop (MIL) simulations, evaluating the performance of various potential strategies. Finally, the proposed strategy is

  5. Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006

    Directory of Open Access Journals (Sweden)

    H Nabavizade

    2007-07-01

    Full Text Available Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descriptive study five hundred eighty operation room staff of ten private and state hospitals in Shiraz completed latex allergy questionnaire. They were questioned about personal history and previous history of latex sensitivity, symptoms of latex reactivity and about other allergies particularly to foods that may cross react with latex. Informed consent was obtained and skin prick testing was performed with natural rubber latex. Skin prick tests were done with three potentially cross reacting food (banana, Kiwi, and potato. The obtained data were analyzed with SPSS software and Chi-square test. Results: Among the 580 operation room workers 104 (17.9 % of participants were positive to latex skin test. We found a significant association between positive skin test to latex in operation room staff and atopy, urticaria and food allergy. Positive skin test to latex related to positive kiwi skin test (p<0.05. The prevalence did not vary by sex, age, education, surgical and non surgical glove users, history of contact dermatitis or smoking status. Conclusion: Latex allergy has a high prevalence in personnel of operation room. Evaluation of present symptom and prediction of future disease necessitate screening test in individuals at risk.

  6. Evaluation of information display at advanced main control room

    Energy Technology Data Exchange (ETDEWEB)

    Min, Dai Hwan; Jo, Heon Jin; Jeon, Byung Ho [Korea Univ., Seoul (Korea, Republic of)

    2001-03-15

    The purpose of this research is first to establish an evaluation method for CBPs(Computer-Based Procedures) at the advanced MCR as a part of regulation technology for the safety of KNGR. The second purpose is to design a prototype of a support system for the evaluation. We have selected the guideline method for the evaluation, since currently there is not any better alternative. Several guidelines have been published for the design of CBPs. The guidelines include both guidance for CBP design process review and guidance for CBP design product review. Although CBPs have many advantages over PBPs(Pater-Based Procedures), they have some drawbacks since CBPs show the information on display screens instead of papers, and generate some new issues that have not been raised with PBPs. For the new issues, we need to be cautious because it is hard to generalize the effects of CBPs and there is no conclusive answer yet. A support system is necessary for the evaluation of CBPs, since it is not easy to carry out an evaluation task even though an evaluator has firm background on cognitive engineering theories and practical experiences. The support system is going to have web-style interface and databases of evaluation items, guidelines for each evaluation item, and technical bases from which a guideline is derived. Evaluation items include those for desirable feature of CBPs and those for a subjective evaluation by the operating crew. The support system will facilitate the task of evaluators by linking evaluation items with technical basis and by providing features for recording and tracing the evaluation result and efforts for resolving the issues identified.

  7. 75 FR 56972 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2010-09-17

    ..., except for certain provisions regarding adequate information and alarm management, which would have a... must implement methods to reduce the risk associated with controller fatigue. In addition, certain... also manage alarms, assure control room considerations are taken into account when changing pipeline...

  8. Demonstration of visualization techniques for the control room engineer in 2030

    DEFF Research Database (Denmark)

    Marinelli, Mattia; Heussen, Kai; Strasser, Thomas

    2017-01-01

    Deliverable 8.1 reports results on analytics and visualizations of real time flexibility in support of voltage and frequency control in 2030+ power system. The investigation is carried out by means of relevant control room scenarios in order to derive the appropriate analytics needed for each...

  9. Room-temperature cw operation of an efficient miniaturized Nd:YAG laser end-pumped by a superluminescent diode

    Energy Technology Data Exchange (ETDEWEB)

    Washio, K.; Iwamoto, K.; Inoue, K.; Hino, I.; Matsumoto, S.; Saito, F.

    1976-12-01

    A miniaturized Nd:YAG laser is described, in which a 3-mm-diam x 5.4-mm-long laser rod is end-pumped by a single Al/sub x/Ga/sub 1-x/As superluminescent diode (SLD) having 20-..mu..m x 1.4-nm stripe geometry. A 4.5-mW laser power was obtained at room temperature in a 1-ms pulse operation. Emitted power from the SLD was 50 mW with 1.7% external power efficiency. When continuously pumped, a 1.5-mW laser power was obtained at room temperature. (AIP)

  10. The current status of procedural sedation for pediatric patients in out-of-operating room locations.

    Science.gov (United States)

    Havidich, Jeana E; Cravero, Joseph P

    2012-08-01

    To illustrate the changes that are occurring in the rapidly growing field of pediatric sedation. In the USA and throughout the world, children receive sedation from a multitude of specialists with varying levels of training. The current pediatric sedation literature reflects a growing body of sedation literature by medical specialists other than anesthesiologists. This article will review the controversial use of propofol by nonanesthesiologists and the manner in which this varied group of providers along with government entities, regulatory agencies, and national organizations contribute to the continuing evolution of sedation practices. The number of diagnostic and therapeutic procedures performed on children outside of the operating room continues to increase. The growing body of pediatric sedation literature suggests anesthesiologists are no longer at the forefront of pediatric sedation training, education, and research. Articles published by nonanesthesiologists describe pediatric sedation services, safety, and quality initiatives, drugs, and original sedation research. Medications that were considered under the realm of anesthesiologists are utilized by nonanesthesiologists to provide sedation to children. Regulating and government agencies, including the Joint Commission and the Center for Medicaid and Medicare Services have recently issued statements on the oversight and practice of sedation. The direction of pediatric sedation is no longer solely under the leadership of anesthesiologists. The use of anesthetic agents, including propofol, have been administered by nonanesthesiologists and reported as safe and effective agents. Nonanesthesiologists and governmental and regulatory agencies influence the delivery of sedation services. The future direction of pediatric sedation will ultimately depend upon the ability of anesthesiologists to collaborate with specialists, hospital administrators, credentialing committees, and oversight agencies in order to

  11. The Role of the Operating Room in Medical Student Education: Differing Perspectives of Learners and Educators.

    Science.gov (United States)

    O'Neill, Rebecca; Shapiro, Michael; Merchant, Aziz

    2017-07-13

    The surgical clerkship is an integral part of third-year medical student education. The operating room (OR) is a heavily used setting, but it is unclear whether this setting is as effective as possible. To determine the role of the OR and potential improvements, it is necessary to analyze the perspectives of those involved, including surgeons, residents, and medical students. An electronic survey was distributed to the surgeons, surgical residents, and third-year medical students associated with Rutgers New Jersey Medical School. The questions were a combination of 5-point Likert scale questions and qualitative responses. The questions assessed the role of the OR, the information taught in the OR, the quality of the teaching and environment, and potential improvements. Attending surgeons and residents generally rated the OR more positively than medical students did. Medical students desired more hands-on participation and a greater focus on learning technical skills. In addition, most medical students rated the feedback and direct instruction in the OR as "poor." Furthermore, the attending surgeons and medical students disagreed about the main roles of the OR as well as the effectiveness of teaching in the OR. The medical students reported experiencing anxiety and intimidation in the OR and suggested several improvements, such as decreasing the length of the surgical clerkship. There is significant disagreement between the surgeons and residents and the medical students regarding the roles and effectiveness of learning in the OR. This may help explain the reported medical student dissatisfaction and frustrations with the surgical clerkship. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Clinical experience with desflurane for paediatric anaesthesia outside the operating room.

    Science.gov (United States)

    Alonso, M; Builes, L; Morán, P; Ortega, A; Fernández, E; Reinoso-Barbero, F

    2017-01-01

    Desflurane has been used in paediatric patients for several surgical indications. This article analyses the efficacy and safety of desflurane for diagnostic-therapeutic procedures in remote areas far from operating room in a group of selected patients with no known associated respiratory disease. A retrospective analysis was performed on 2,072 general anaesthesia procedures stored in a computer database, in which desflurane was used in a Paediatric Pain Unit during the years 2013 and 2014. An analysis was also performed using the patient demographics, type of procedure, anaesthetic technique, type of airway management, patient cooperation, and incidence of anaesthetic complications. The study included 876 patients, with a mean age of 8.8 years. The main procedures were bone marrow aspirates (23%), lumbar punctures (20%), panendoscopies (15%), and colonoscopies (5%). Induction was intravenous with propofol (26%) or inhalation with sevoflurane in the remaining 74%. Maintenance consisted of remifentanil and desflurane at mean end tidal concentrations of 6.2±2.1%. The airway was managed through a nasal cannula or face mask in spontaneous ventilation. The effectiveness was 98%, and the incidence of side effects was 15%, which included agitation (6%), headache (4%), nausea-vomiting (3%), and laryngospasm (2%). The maintenance with desflurane (at concentrations close to the hypnotic-MAC in spontaneous ventilation) was effective, with a rapid recovery, and with a low incidence of adverse effects. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Brain Tumor Interface Dissection Technique with Surgical Blade from Laboratory to Neurosurgical Operating Room.

    Science.gov (United States)

    Rai, Survendra Kumar R; Mancarella, Cristina; Goel, Atul H

    2017-04-01

    Ideal tumor resection requires brain/spinal cord tumor interface separation in perfect and precise surgical planes within a few micrometers for radical tumor resection and maximum normal tissue preservation. Despite the availability of several dissection techniques, the search for additional alternatives and an ideal technique continues. We evaluated the feasibility and advantages of dissection using a No. 15-blade scalpel in special brain tumor surgery situations. We developed a leaf model wherein its outer layer is progressively dissected from its inner skeleton using a scalpel. An additional model used was a tomato wherein its skin was peeled off its pulp using the same technique. We developed an inexpensive leaf model. A scalpel knife was used in a microneurosurgical setting, and the leaf's outer layer is peeled off. The technique is then used in an operating room setup where surgery on extra-axial tumors like meningiomas and intra-axial brain and spinal cord tumors is done. A No. 15 scalpel was used for dissection between the layers of the Peltophorum pterocarpum leaf model. This dissection method was compared with other neurosurgical dissecting tools. We dissected 120-μm thick leaves into 2 layers with removal of an 18- to 55-μm thick layer. Leaving behind a transparent layer was possible using a No. 15 blade scalpel. Similarly, it was possible to preserve a 35- to 40-μm thick arachnoid layer that separated a meningioma from the underlying brain parenchyma. A scalpel with a sharp edge could be used to perform precise and fine dissection. The scalpel deserves to occupy a place of pride as a dissecting tool in neurosurgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Evaluation of information display at advanced main control room

    Energy Technology Data Exchange (ETDEWEB)

    Min, Dae Hwan; Yu, Seon Jae; Choi, Eui Sun [Korea Univ., Seoul (Korea, Republic of)

    2000-03-15

    This year we plan to survey information in order to have basic understanding of digital information display and control at the advanced MCR. At first we collect different ways of presenting information at the advanced MCR. Secondly, we conduct literature survey on studies that have investigated information representation techniques and their effects. Then, we need compare differences between conventional NPPs and advanced NPPs. Thirdly, we need to check HMI styles and evaluation techniques that are used currently at foreign NPPs. Indeed, HMI at the advanced MCR is quite different from that at a conventional MCR. It is not desirable to apply the same evaluation technique that has veen used at the conventional MCR. We need to develop an evaluation technique that is valid in theory and applicable in practice. Finally, we identify the requirements for a support system for an HMI evaluator, since it is not easy to carry out an evaluation task even though one has firm background on cognitive engineering theories and practical experiences.

  15. Evaluating The Operation Of Three Air Cleaners Working Individually In A Clean Room

    DEFF Research Database (Denmark)

    Ardkapan, Siamak Rahimi; Afshari, Alireza; Bergsøe, Niels Christian

    2011-01-01

    The use of portable air cleaners is becoming increasingly popular in many countries including Denmark. Portable air cleaners are known for not only removing but also generating particles and gases. To clarify this, three air cleaning technologies were evaluated. They were nonthermal plasma......, photochemical air purifier and corona discharge ionizer. The concentrations of ultrafine particles, ozone and total volatile organic compounds were measured both in a duct and in a clean room. It was found that the studied air cleaning technologies increased the ozone level in the clean room and the duct....... The increase of ozone level in the clean room was more than that was measured in the duct. Additionally, it was found that the number of ultrafine particles in the room increased due to the generated ozone. The number of generated particles changed with the season. The study leads to the recommendation...

  16. Data-driven spatio-temporal RGBD feature encoding for action recognition in operating rooms.

    Science.gov (United States)

    Twinanda, Andru P; Alkan, Emre O; Gangi, Afshin; de Mathelin, Michel; Padoy, Nicolas

    2015-06-01

    Context-aware systems for the operating room (OR) provide the possibility to significantly improve surgical workflow through various applications such as efficient OR scheduling, context-sensitive user interfaces, and automatic transcription of medical procedures. Being an essential element of such a system, surgical action recognition is thus an important research area. In this paper, we tackle the problem of classifying surgical actions from video clips that capture the activities taking place in the OR. We acquire recordings using a multi-view RGBD camera system mounted on the ceiling of a hybrid OR dedicated to X-ray-based procedures and annotate clips of the recordings with the corresponding actions. To recognize the surgical actions from the video clips, we use a classification pipeline based on the bag-of-words (BoW) approach. We propose a novel feature encoding method that extends the classical BoW approach. Instead of using the typical rigid grid layout to divide the space of the feature locations, we propose to learn the layout from the actual 4D spatio-temporal locations of the visual features. This results in a data-driven and non-rigid layout which retains more spatio-temporal information compared to the rigid counterpart. We classify multi-view video clips from a new dataset generated from 11-day recordings of real operations. This dataset is composed of 1734 video clips of 15 actions. These include generic actions (e.g., moving patient to the OR bed) and actions specific to the vertebroplasty procedure (e.g., hammering). The experiments show that the proposed non-rigid feature encoding method performs better than the rigid encoding one. The classifier's accuracy is increased by over 4 %, from 81.08 to 85.53 %. The combination of both intensity and depth information from the RGBD data provides more discriminative power in carrying out the surgical action recognition task as compared to using either one of them alone. Furthermore, the proposed non

  17. Low-threshold room-temperature continuous-wave operation of a terahertz difference-frequency quantum cascade laser source

    Science.gov (United States)

    Fujita, Kazuue; Ito, Akio; Hitaka, Masahiro; Dougakiuchi, Tatsuo; Edamura, Tadataka

    2017-08-01

    The performance of a room-temperature continuous-wave (CW) terahertz source based on intracavity difference-frequency generation in a mid-infrared (λ ∼ 6.8 µm) quantum cascade laser with a dual-upper-state active region is reported. The fabricated buried heterostructure device, with a two-section buried distributed feedback grating, operates at two mid-infrared wavelengths and demonstrates a terahertz output of 2.92 THz with a very low threshold current density of 0.89 kA/cm2 in pulsed operation. Consequently, despite an epitaxial-side-up mounting configuration, the device achieves CW operation at room temperature in which a low CW threshold current density of 1.3 kA/cm2 is obtained.

  18. Three distinct surgical clothing systems in a turbulent mixing operating room equipped with mobile ultraclean laminar airflow screen

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Holmberg, Sture; Nielsen, Peter Vilhelm

    2016-01-01

    Two types of mobile screens producing ultraclean local laminar airflow were investigated as an addition to turbulent mixing operating room ventilation. The exploration was carried out numerically using computational fluid dynamics. Surface and volumetric particle counts were simulated on the oper......Two types of mobile screens producing ultraclean local laminar airflow were investigated as an addition to turbulent mixing operating room ventilation. The exploration was carried out numerically using computational fluid dynamics. Surface and volumetric particle counts were simulated...... on the operating and instrument tables with and without the additional mobile airflow screen. Three different source strengths (the mean bacteria-carrying particle value emitted from one person per second) due to staff clothing variety were considered. Model validation was performed through result comparisons...... with experimental data from the literature. Results confirmed that the mobile screen units reduced the airborne bacteria to an acceptable level for infection-prone surgeries. No significant particle concentration differences existed in the periphery of the operating room. Lower source strength resulting from...

  19. Acceptability of Low Level White Lighting in the Control Room at Sea

    Science.gov (United States)

    2014-08-05

    LIGHTING IN THE CONTROL ROOM AT SEA by S. M. Luria and D. A. Kobus Naval Medical Research and Development Command Research Work Unit M0100.001...release; distribution unlimited. ACCEPTABILITY OF LOW LEVEL WHITE LIGHTING " IN THE CONTROL ROOM AT SEA by S. M. Luria , Ph.D. David A. Kobus, LT...ltr 9330 Ser 51/434 to CO, NSMRL of 18 Nov 1984. 3 Luria , S. M. and David A. Kobus. The relative effectiveness of red and white light for

  20. Control-based operating system design

    CERN Document Server

    Leva, Alberto; Papadopoulos, AV; Terraneo, F

    2013-01-01

    This book argues that computer operating system components should be conceived from the outset as controllers, synthesised and assessed in the system-theoretical world of dynamic models, and then realised as control algorithms.

  1. An Investigation for Arranging the Video Display Unit Information in a Main Control Room of Advanced Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Chong Cheng; Yang, Chih Wei [Institute of Nuclear Energy Research, Atomic Energy Council, Taoyuan (China)

    2014-08-15

    Current digital instrumentation and control and main control room (MCR) technology has extended the capability of integrating information from numerous plant systems and transmitting needed information to operations personnel in a timely manner that could not be envisioned when previous generation plants were designed and built. A MCR operator can complete all necessary operating actions on the video display unit (VDU). It is extremely flexible and convenient for operators to select and to control the system display on the screen. However, a high degree of digitalization has some risks. For example, in nuclear power plants, failures in the instrumentation and control devices could stop the operation of the plant. Human factors engineering (HFE) approaches would be a manner to solve this problem. Under HFE considerations, there exists 'population stereotype' for operation. That is, the operator is used to operating a specific display on the specific VDU for operation. Under emergency conditions, there is possibility that the operator will response with this habit population stereotype, and not be aware that the current situation has already changed. Accordingly, the advanced nuclear power plant should establish the MCR VDU configuration plan to meet the consistent teamwork goal under normal operation, transient and accident conditions. On the other hand, the advanced nuclear power plant should establish the human factors verification and validation plan of the MCR VDU configuration to verify and validate the configuration of the MCR VDUs, and to ensure that the MCR VDU configuration allows the operator shift to meet the HFE consideration and the consistent teamwork goal under normal operation, transient and accident conditions. This paper is one of the HF V V plans of the MCR VDU configuration of the advanced nuclear power plant. The purpose of this study is to confirm whether the VDU configuration meets the human factors principles and the consistent

  2. Controlling operational risk: Concepts and practices

    NARCIS (Netherlands)

    van den Tillaart, A.H.A.J.

    2003-01-01

    The subject of this thesis is controlling 'operational risk' in banks. Operational risk is defined as the risk of losses resulting from inadequate or failed internal processes, people, systems, or from external events. Within this very broad subject, we focus on the place of operational risk

  3. Application of Digital Operating Room%浅谈数字化手术室的应用

    Institute of Scientific and Technical Information of China (English)

    韩雪峰; 雍维林

    2012-01-01

    介绍了数字化手术室的概念和具体功能,分析了数字化手术室在安全的手术环境、医院系统集成、教学及学术交流等方面的应用,并从提升医疗安全和质量、提高工作效率、监控医疗过程、提高医院信息化管理水平等方面详细阐述了数字化手术室应用效果,指出了数字化手术室是医院数字化建设的重要组成部分,为医院带来直接的经济效益和社会效益,提高了医院的核心竞争力,是医院数字化的必然趋势.%Hie concept and specific functions of digital operating room are introduced, and the application of digital operating room in safe operation environment, hospital system integration, teaching and academic exchanges is analyzed. The application effect of digital operating room is expounded from upgrading medical security and quality, improving work efficiency, monitoring medical process, and heightening hospital information management level, etc. It is pointed out that the digital operating room is an important part for the construction of digital hospital, which can bring direct economic and social benefits for hospital, enhance the core competitiveness of hospital, and is the inevitable trend of digital hospital. [Chinese Medical Equipment Journal,2012,33(4):101-103

  4. A class of symmetric controlled quantum operations

    CERN Document Server

    Vaccaro, J A; Huelga, S F; Vaccaro, John A.

    2001-01-01

    Certain quantum gates, such as the controlled-NOT gate, are symmetric in terms of the operation of the control system upon the target system and vice versa. However, no operational criteria yet exist for establishing whether or not a given quantum gate is symmetrical in this sense. We consider a restricted, yet broad, class of two-party controlled gate operations for which the gate transforms a reference state of the target into one of an orthogonal set of states. We show that for this class of gates it is possible to establish a simple necessary and sufficient condition for the gate operation to be symmetric.

  5. A class of symmetric controlled quantum operations

    Energy Technology Data Exchange (ETDEWEB)

    Vaccaro, John A.; Steuernagel, O.; Huelga, S.F. [Division of Physics and Astronomy, Department of Physical Sciences, University of Hertfordshire, Hatfield (United Kingdom)

    2001-09-07

    Certain quantum gates, such as the controlled-NOT gate, are symmetric in terms of the operation of the control system upon the target system and vice versa. However, no operational criteria yet exist for establishing whether or not a given quantum gate is symmetrical in this sense. We consider a restricted, yet broad, class of two-party controlled gate operations for which the gate transforms a reference state of the target into one of an orthogonal set of states. We show that for this class of gates it is possible to establish a simple necessary and sufficient condition for the gate operation to be symmetric. (author)

  6. Control console for the X-ray room; Consola de control para la sala de rayos X

    Energy Technology Data Exchange (ETDEWEB)

    Garcia H, J.M.; Aguilar B, M.A.; Torres B, M.A

    1998-07-01

    It is presented the design and construction of Control console for the X-ray room of Metrology Center for ionizing radiations at National Institute of Nuclear Research (ININ). This system controls the positioning of 6 different filters for an X-ray beam. Also it controls a shutter which blockades the beam during periods established by user, these periods can be fixed from hours until tenth of second. The shutter opening periods, as well as the X-ray beam filter are establish and monitoring from a Personal computer outside of room. (Author)

  7. Resident Physicians Improve Nontechnical Skills When on Operating Room Management and Leadership Rotation.

    Science.gov (United States)

    Cole, Devon C; Giordano, Christopher R; Vasilopoulos, Terrie; Fahy, Brenda G

    2017-01-01

    Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015. Each resident served as the anesthesiology officer of the day (AOD) and was tasked with coordinating OR assignments, managing care for 2 to 4 ORs, and being on call for the trauma OR; all residents were supervised by an attending AOD. Leadership and NTS techniques were taught via a standardized curriculum consisting of leadership and team training articles, crisis management text, and daily debriefings. Resident self-ratings and attending AOD and charge nurse raters used the Anaesthetists' Non-Technical Skills (ANTS) scoring system, which involved task management, situational awareness, teamwork, and decision making. For each of the 10 residents in their third year of clinical anesthesiology training (CA-3) who participated in this elective rotation, there were 14 items that required feedback from resident self-assessment and OR raters, including the daily attending AOD and charge nurse. Results for each of the items on the questionnaire were compared between the beginning and the end of the rotation with the Wilcoxon signed-rank test for matched samples. Comparisons were run separately for attending AOD and charge nurse assessments and resident self-assessments. Scaled rankings were analyzed for the Kendall coefficient of concordance (ω) for rater agreement with associated χ and P value. Common themes identified by the residents during debriefings were recurrence of challenging situations and the skills residents needed to instruct and manage clinical teams. For

  8. Thinking in three's: Changing surgical patient safety practices in the complex modern operating room

    Institute of Scientific and Technical Information of China (English)

    Verna C Gibbs

    2012-01-01

    The three surgical patient safety events,wrong site surgery,retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study.The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined.Many providers may never have a personal experience with one of these events and training and education on these topics are sparse.These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do.Surgeons are not preoccupied with failure and tend to usually consider good outcomes,which leads them to ignore or diminish the importance of implementing and following simple safety practices.These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions.Individual facilities rarely have the time or talent to understand these events and develop lasting solutions.More often than not,even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate.This approach routinely fails and is another reason why these problems are so persistent.Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment.This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery,RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists,surgeons and nurses.A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team

  9. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  10. General predictive control using the delta operator

    DEFF Research Database (Denmark)

    Jensen, Morten Rostgaard; Poulsen, Niels Kjølstad; Ravn, Ole

    1993-01-01

    This paper deals with two-discrete-time operators, the conventional forward shift-operator and the δ-operator. Both operators are treated in view of construction of suitable solutions to the Diophantine equation for the purpose of prediction. A general step-recursive scheme is presented. Finally...... a general predictive control (GPC) is formulated and applied adaptively to a continuous-time plant...

  11. Power generation, operation and control

    CERN Document Server

    Wood, Allen J; Sheblé, Gerald B

    2013-01-01

    Since publication of the second edition, there have been extensive changes in the algorithms, methods, and assumptions in energy management systems that analyze and control power generation. This edition is updated to acquaint electrical engineering students and professionals with current power generation systems. Algorithms and methods for solving integrated economic, network, and generating system analysis are provided. Also included are the state-of-the-art topics undergoing evolutionary change, including market simulation, multiple market analysis, multiple interchange contract analysis, c

  12. Computer control for remote wind turbine operation

    Energy Technology Data Exchange (ETDEWEB)

    Manwell, J.F.; Rogers, A.L.; Abdulwahid, U.; Driscoll, J. [Univ. of Massachusetts, Amherst, MA (United States)

    1997-12-31

    Light weight wind turbines located in harsh, remote sites require particularly capable controllers. Based on extensive operation of the original ESI-807 moved to such a location, a much more sophisticated controller than the original one has been developed. This paper describes the design, development and testing of that new controller. The complete control and monitoring system consists of sensor and control inputs, the control computer, control outputs, and additional equipment. The control code was written in Microsoft Visual Basic on a PC type computer. The control code monitors potential faults and allows the turbine to operate in one of eight states: off, start, run, freewheel, low wind shut down, normal wind shutdown, emergency shutdown, and blade parking. The controller also incorporates two {open_quotes}virtual wind turbines,{close_quotes} including a dynamic model of the machine, for code testing. The controller can handle numerous situations for which the original controller was unequipped.

  13. A System Approach to Navy Medical Education and Training. Appendix 36. Competency Curriculum for Operating Room Assistant and Operating Room Technician.

    Science.gov (United States)

    1974-08-31

    101 2. Peripheral-Vascular Procedures . . . .. .. . .102 3. Abdominal-Vascular Procedures . . . . . . . . . . 103 XII : Scrubbing for Cardiac...ORP) Unit XII : Scr’boing fcr Ca- iac Procadures 2MO D𔃼 1: CLOSED C*.". .C Pp-r .... TASYS a. Scrub for naricardiocto:iy b. Scrub for comiissurotomy...dona for and to him, transfar patient to operating tabla and taka any nece3sary naures to pzovida for patie3nt’ 3 aafety und co-mfort (Crit~azia

  14. Gargamelle in the West Area - control room for the external electronic detectors

    CERN Multimedia

    1977-01-01

    Four electronic detectors complementing Gargamelle were installed in 1977, among them the external muon identifier (EMI), consisting of two arrays of multiwire proportional chambers separated by an iron wall (see Annual Report 1977 p. 84). The photo shows the control room close to the West Gargamelle Hall (Bld. 185).

  15. Virtual Visit to the ATLAS Control Room by various towns in Uruguay

    CERN Multimedia

    2013-01-01

    Anilla Cultural Latinoamérica – Europa in Uruguay is a venture between ANEP, CES and UDELAR. In its line of action of scientific and technological culture they contact CERN for an open dialogue to divulge science, led to its teachers and students. The virtual "visit" of Uruguay at CERN is done from multiple video conferencing rooms in the country through the Uruguayan Academic Network. On 28th May six towns in Uruguay will be connected to the ATLAS Control Room: Montevideo, Maldonado, Rocha, Tacuarembó, Salto and Rivera.

  16. Contamination of the operating room by anesthetic gases and vapors. II. Gas chromatographic analysis of nitrous oxide

    Energy Technology Data Exchange (ETDEWEB)

    Cattaneo, A.D.; Ferraiolo, G.; Rovatti, M.; Zattoni, J.; Donato, A.

    1981-12-01

    The contamination by nitrous oxide of an operating room atmosphere was studied in a number of experiments, in the absence of personnel and using a gaschromatographic method. The evacuating device of the anesthesia machine proved to be ineffective to overcome the hazard of leaks in the breathing system, whereas the air conditioning flow rates (12 outside air changes per hour) minimized waste anesthetic gas concentrations.

  17. Private Hospital La Clinique de La Qiataigneraie Deployed Wi-Fi Network to Optimize the Management of its Operating Rooms

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Symbol Technologies, Inc. (NYSE:SBL), The Enterprise Mobility Company, and Ekahau, one of the leading suppliers of Wi-Fi positioning solutions, today announced that the La Chataigneraie private clinic implemented the Ekahau Real Time Location System (RTLS) solution. The wireless solution incorporates two Symbol WS5100 wireless switches and 30 AP300 access ports, and is used to improve communications in and between its 16 operating rooms.

  18. Simple operated multipurpose temperature control cryostat

    Institute of Scientific and Technical Information of China (English)

    ABBAS T.A.; OMAR M.S.

    2007-01-01

    A suitable simple optical cryostat for optical, magneto-optical, electrical and thermo-electrical measurements was designed. It is suitable for use in a magnetic pool gap as narrow as less than 1 cm. Throughout a long period of time, the heat diffusion process of the cryostat can be easily operated at slow increase in sample temperature in a range 1.25 K/min at 200 K that will be reduced gradually to 0.66 K at room temperature. Liquid nitrogen was used to cool down the temperature. During the operation, the change in the measured energy gap of a semiconductor sample and other physical parameters resulting from the change of temperature can be corrected through the temperature coefficient of that parameter at the corresponding temperature.The cryostat was successfully used for all experiments mentioned above to measure the properties of a single crystal of GaP (Gallium Phosphate) semiconductor.

  19. Assessment of Clinical Stressful Factors Among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences (2015

    Directory of Open Access Journals (Sweden)

    Mojtaba Raji

    2016-07-01

    Full Text Available Background and Objective: Nursing students are exposed to clinical environmental stresses in addition to educational environmental stresses. The aim of this study was to assessment of clinical stressful factors among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences in 2015.Materials and Methods: This study was a description-analytical study with 234 students of nursing and operation room up to two semesters for enrolled. Data was using a self-made researcher Questionnaire consisted of demographic information and clinical stressful factors. Data analysis was performed by descriptive and inferential statistics using SPSS-PC (v.20.Results: The findings showed that the main stressors in students of nursing and operation room were unpleasant emotions and least stressful areas were interpersonal communication in a clinical environment. The results showed that the average score of the field of education and humiliating experiences using Spearman correlation test (P=0/045 (r=0/16.Conclusion: Study showed, the mean stress is the moderate level. Stressful areas obtained in the four areas of personal communication, clinical practice stressful, unpleasant feelings and humiliating experience that fortunately, in many cases reform and change.

  20. Physician communication in the operating room: expanding application of face-negotiation theory to the health communication context.

    Science.gov (United States)

    Kirschbaum, Kristin

    2012-01-01

    Communication variables that are associated with face-negotiation theory were examined in a sample of operating-room physicians. A survey was administered to anesthesiologists and surgeons at a teaching hospital in the southwestern United States to measure three variables commonly associated with face-negotiation theory: conflict-management style, face concern, and self-construal. The survey instrument that was administered to physicians includes items that measured these three variables in previous face-negotiation research with slight modification of item wording for relevance in the medical setting. The physician data were analyzed using confirmatory factor analysis, Pearson's correlations, and t-tests. Results of this initial investigation showed that variables associated with face-negotiation theory were evident in the sample physician population. In addition, the correlations were similar among variables in the medical sample as those found in previous face-negotiation research. Finally, t-tests suggest variance between anesthesiologists and surgeons on specific communication variables. These findings suggest three implications that warrant further investigation with expanded sample size: (1) An intercultural communication theory and instrument can be utilized for health communication research; (2) as applied in a medical context, face-negotiation theory can be expanded beyond traditional intercultural communication boundaries; and (3) theoretically based communication structures applied in a medical context could help explain physician miscommunication in the operating room to assist future design of communication training programs for operating-room physicians.

  1. MULTI - TRACER CONTROL ROOM AIR INLEAKAGE PROTOCOL AND SIMULATED PRIMARY AND EXTENDED MULTI - ZONE RESULTS.

    Energy Technology Data Exchange (ETDEWEB)

    DIETZ,R.N.

    2002-01-01

    The perfluorocarbon tracer (PFT) technology can be applied simultaneously to the wide range in zonal flowrates (from tens of cfms in some Control Rooms to almost 1,000,000 cfm in Turbine Buildings), to achieve the necessary uniform tagging for subsequent determination of the desired air inleakage and outleakage from all zones surrounding a plant's Control Room (CR). New types of PFT sources (Mega sources) were devised and tested to handle the unusually large flowrates in a number of HVAC zones in power stations. A review of the plans of a particular nuclear power plant and subsequent simulations of the tagging and sampling results confirm that the technology can provide the necessary concentration measurement data to allow the important ventilation pathways involving the Control Room and its air flow communications with all adjacent zones to be quantitatively determined with minimal uncertainty. Depending on need, a simple single or 3-zone scheme (involving the Control Room alone or along with the Aux. Bldg. and Turbine Bldg.) or a more complex test involving up to 7 zones simultaneously can be accommodated with the current revisions to the technology; to test all the possible flow pathways, several different combinations of up to 7 zones would need to be run. The potential exists that for an appropriate investment, in about 2 years, it would be possible to completely evaluate an entire power plant in a single extended multizone test with up to 12 to 13 separate HVAC zones. With multiple samplers in the Control Room near each of the contiguous zones, not only will the prevalent inleakage or outleakage zones be documented, but the particular location of the pathway's room of ingress can be identified. The suggested protocol is to perform a 3-zone test involving the Control Room, Aux. Bldg., and Turbine Bldg. to (1) verify CR total inleakage and (2) proportion that inleakage to distinguish that from the other 2 major buildings and any remaining untagged

  2. 手术室护理带教方法的探讨和学习%Discussion and Study on Teaching Methods of Nursing Teaching in Operation Room

    Institute of Scientific and Technical Information of China (English)

    贺俭

    2016-01-01

    Objective To investigate the operating room nursing teaching method and effect. Methods Hospital from January 2015 to December 2015 30 cases of operating room nursing students as research subjects were randomly divided into two groups to take the way, each 15 nursing students were named as the observation group and the control group. For nursing students in the control group using traditional teaching methods with, for the observation group of nursing students use group learning with teaching. Results The nursing students theoretical test scores, test scores as well as the operation of teaching work satisfaction rate was higher nursing students. Conclusion The group learning with teaching applied operating room nursing teaching work significant effect can be widely promoted.%目的探讨手术室护理带教方法及效果。方法将我院2015年1月~12月30例手术室护生作为研究对象,采取随机分成两组的方式,每组15名护生,分别命名为观察组和对照组。对对照组护生采用传统带教法,对观察组护生采用小组学习带教法,对比两组护生带教的效果。结果观察组护生理论考试成绩、操作考试成绩以及对带教工作的满意率均高于对照组护生。结论将小组学习带教法应用于手术室护理带教工作中效果显著,可进行广泛推广。

  3. Nuclear thermal rocket engine operation and control

    Science.gov (United States)

    Gunn, Stanley V.; Savoie, Margarita T.; Hundal, Rolv

    1993-06-01

    The operation of a typical Rover/Nerva-derived nuclear thermal rocket (NTR) engine is characterized and the control requirements of the NTR are defined. A rationale for the selection of a candidate diverse redundant NTR engine control system is presented and the projected component operating requirements are related to the state of the art of candidate components and subsystems. The projected operational capabilities of the candidate system are delineated for the startup, full-thrust, shutdown, and decay heat removal phases of the engine operation.

  4. A Distributed Control System Prototyping Environment to Support Control Room Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Lew, Roger Thomas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald Laurids [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ulrich, Thomas Anthony [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-12-01

    Operators of critical processes, such as nuclear power production, must contend with highly complex systems, procedures, and regulations. Developing human-machine interfaces (HMIs) that better support operators is a high priority for ensuring the safe and reliable operation of critical processes. Human factors engineering (HFE) provides a rich and mature set of tools for evaluating the performance of HMIs, however the set of tools for developing and designing HMIs is still in its infancy. Here we propose a rapid prototyping approach for integrating proposed HMIs into their native environments before a design is finalized. This approach allows researchers and developers to test design ideas and eliminate design flaws prior to fully developing the new system. We illustrate this approach with four prototype designs developed using Microsoft’s Windows Presentation Foundation (WPF). One example is integrated into a microworld environment to test the functionality of the design and identify the optimal level of automation for a new system in a nuclear power plant. The other three examples are integrated into a full-scale, glasstop digital simulator of a nuclear power plant. One example demonstrates the capabilities of next generation control concepts; another aims to expand the current state of the art; lastly, an HMI prototype was developed as a test platform for a new control system currently in development at U.S. nuclear power plants. WPF possesses several characteristics that make it well suited to HMI design. It provides a tremendous amount of flexibility, agility, robustness, and extensibility. Distributed control system (DCS) specific environments tend to focus on the safety and reliability requirements for real-world interfaces and consequently have less emphasis on providing functionality to support novel interaction paradigms. Because of WPF’s large user-base, Microsoft can provide an extremely mature tool. Within process control applications,WPF is

  5. The Design and Research of the Operation Status Detector for Marine Engine Room Power Plant Based on Noise

    Directory of Open Access Journals (Sweden)

    Li Hang

    2016-01-01

    Full Text Available Designed in this paper, based on the noise of ship engine room power plant running status of detector, is mainly used in the operation of the power plant of acoustic shell size to determine when the machine running state, this device is composed of signal disposal and alarm display adjustment part of two parts. Detector that can show the size of the voice, if exceed the set limit alarm value, the detector can sound an alarm, to remind staff equipment fails, it shall timely inspection maintenance, improve the safety of the operation of the ship.

  6. Co-operatives and Normative Control

    DEFF Research Database (Denmark)

    Bregn, Kirsten; Jagd, Søren

    1992-01-01

    This paper explores the conditions for applying normative control in co-operatives. For normative control to be effective two conditions are found particularly important: Individuals must be morally involved and the organization must have a system of making it possible to link common norms...... to other organizations because of the special features of co-operative organizations: use of normative control, democratic decision-making, and decentralized organizational structure. On the other hand, however, there may be strong barriers in co-operatives against creating a sufficient information system....

  7. Chapter 8: Plasma operation and control

    Science.gov (United States)

    Gribov, Y.; Humphreys, D.; Kajiwara, K.; Lazarus, E. A.; Lister, J. B.; Ozeki, T.; Portone, A.; Shimada, M.; Sips, A. C. C.; Wesley, J. C.

    2007-06-01

    The ITER plasma control system has the same functional scope as the control systems in present tokamaks. These are plasma operation scenario sequencing, plasma basic control (magnetic and kinetic), plasma advanced control (control of RWMs, NTMs, ELMs, error fields, etc) and plasma fast shutdown. This chapter considers only plasma initiation and plasma basic control. This chapter describes the progress achieved in these areas in the tokamak experiments since the ITER Physics Basis (1999 Nucl. Fusion 39 2577) was written and the results of assessment of ITER to provide the plasma initiation and basic control. This assessment was done for the present ITER design (15 MA machine) at a more detailed level than it was done for the ITER design 1998 (21 MA machine) described in the ITER Physics Basis (1999 Nucl. Fusion 39 2577). The experiments on plasma initiation performed in DIII-D and JT-60U, as well as the theoretical studies performed for ITER, have demonstrated that, within specified assumptions on the plasma confinement and the impurity influx, ITER can produce plasma initiation in a low toroidal electric field (0.3 V m-1), if it is assisted by about 2 MW of ECRF heating. The plasma basic control includes control of the plasma current, position and shape—the plasma magnetic control, as well as control of other plasma global parameters or their profiles—the plasma performance control. The magnetic control is based on more reliable and simpler models of the control objects than those available at present for the plasma kinetic control. Moreover the real time diagnostics used for the magnetic control in many cases are more precise than those used for the kinetic control. Because of these reasons, the plasma magnetic control was developed for modern tokamaks and assessed for ITER better than the kinetic control. However, significant progress has been achieved in the plasma performance control during the last few years. Although the physics basis of plasma operation

  8. Experience of Interview Before and After Operation in Operating Room%手术室术前术后访视体会

    Institute of Scientific and Technical Information of China (English)

    陈保清

    2015-01-01

    Objective: To explore the effect of interview before and after operation on nursing works in operating room. Methods: Full-time interviewing nurses were appointed to the operating room to read the medical records of patients who were going to receive operation on the next day. Preoperative directions were given to the patients according to their conditions. The psychological characteristics of the patients were analyzed and right psychological counselings were given to the patients. Results: The interview before and after operation can improve the nursing quality in operating room and the preoperative psychological condition of the patients. It is good for the performance of the operation and increase the comfort of the patients in hospital.%目的:探讨术前、术后访视在手术室护理工作中的护理体会。方法:手术室指定专职的访视护士,在手术前1 d查阅第2 d需要手术的患者病历,根据情况对患者进行术前指导,了解患者心理特点,及时给患者提供正确的心理疏导。结果:通过术前、术后访视提高了手术室护理质量,有利于患者术前心理状态的改善,有助于手术的顺利进行,提高了患者在医院的舒适度。

  9. Strategies and Decision Support Systems for Integrating Variable Energy Resources in Control Centers for Reliable Grid Operations

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Lawrence E. [Alstom Grid Inc., Washington, DC (United States)

    2011-11-01

    This report provides findings from the field regarding the best ways in which to guide operational strategies, business processes and control room tools to support the integration of renewable energy into electrical grids.

  10. Strategies and Decision Support Systems for Integrating Variable Energy Resources in Control Centers for Reliable Grid Operations. Executive Summary

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Lawrence E. [Alstom Grid, Inc., Washington, DC (United States)

    2011-11-01

    This is the executive summary for a report that provides findings from the field regarding the best ways in which to guide operational strategies, business processes and control room tools to support the integration of renewable energy into electrical grids.

  11. Room transfers and the risk of delirium incidence amongst hospitalized elderly medical patients: a case?control study

    OpenAIRE

    Goldberg, Amanda; Sharon E Straus; Hamid, Jemila S; Wong, Camilla L.

    2015-01-01

    Background Room transfers are suspected to promote the development of delirium in hospitalized elderly patients, but no studies have systematically examined the relationship between room transfers and delirium incidence. We used a case?control study to determine if the number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients, controlling for baseline risk factors. Methods We included patients 70?years of age ...

  12. INSURANCE OF KNITTED PRODUCTS QUALITY THROUGH THE ANALYSIS AND EVALUATION OF NON-QUALITY DURING THE OPERATIONS IN THE CUTTING ROOM

    Directory of Open Access Journals (Sweden)

    LUTIC Liliana

    2014-05-01

    Full Text Available n a knitting- confection profile factory, any activity oriented toward evaluation, maintenance or improvement of products quality level is based on measuring and examining the product quality characteristics, in order to establish conformity to the quality specifications and/or naming the non-quality characteristics (establishing defects and fabrication deficiencies. We can consider non-quality as complementary to quality, although a definitive distinction cannot always be made between the two categories or states. Cutting holds a key role in insuring shape precision and pieces dimensions, determining the quality of the confection process, its structure and manual stages frequency. The quality of the cutting operation, appreciated through the precision and aspect of cut contours, existence and precision of markings, is directly reflected in the finite product’s quality, which entails knowledge of cutting instrument - fabric interactions. In compliance of the technological regime during the operations in the cutting room can determine: incorrect marking, spreading, sectioning or cutting. Non-quality of intermediate products obtained in the cutting department can be evaluated and controlled through defectologic control methods.The De – Ca – Re method (defect-cause-remedy correlation, applied in this paper, allows establishing the most important causes that generate defects, as well as preventive and corrective actions to eliminate these causes. This paper systematically presents the main defects that may occur during operations in the cutting room, causes that generate these defects, along with their preventive and corrective actions.

  13. Analysis results for the stereotypes regarding colors applied to the nuclear power plant control room

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Oh, In Seok; Lee, Yong Hee; Lee, Hyun Chul [KAERI, Taejon (Korea, Republic of); Lee, Dhong Ha [Suwon Univ., Suwon (Korea, Republic of)

    2003-01-01

    The general public not engaged in the nuclear power plant industry have no idea of the color usage in the nuclear control room. So we converted the specific color usage situation into similar but general situations. In questionnaire, we gave subjects the general situation where color coding is applied and alternative colors which were applied to the HF010 guidelines. And we asked the subjects to choose the colors proper to the situation and to rank the colors according to the degree of suitability. Two hundred fifty college students participated in the experiment. The results suggest that we can use any color coding system in the conventional control room and the CRT in the control deck because most people have no special previous color-meaning association but red-emergency relation.

  14. Virtual Visit to the ATLAS Control Room by the Frankfurt Book Fair

    CERN Multimedia

    ATLAS Experiment

    2012-01-01

    The Frankfurt book fair is the largest of its kind in Germany, attracting about 300,000 visitors during five days. CERN will be present with a large stand, incorporating a virtual LHC control centre, a table featuring books on CERN for the general public, an interactive LHC tunnel and a presentation stage. E